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General NPI Number Information
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NPI Number | 1700481140
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Entity Type | Individual
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Provider Name | NICOLE MARIE BIALECKI MA
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Gender | Female
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Dates
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Enumeration Date | 12/03/2020
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Last Update Date | 11/03/2025
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Provider Practice Location Address
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Address Line | 706 BLOOM RD
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City | DANVILLE
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State | PA
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Zip | 17821-1367
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Country | US
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Telephone | 570-218-8309
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Fax |
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Provider Business Mailing Address
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Address Line | 357 EAST ST
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City | BLOOMSBURG
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State | PA
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Zip | 17815-1846
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Country | US
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Telephone | 570-316-5171
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC019491
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License Number State | PA
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