Edward Leonard Bielawski, M.A.

Individual provider Active NPI Psychologist · Olyphant, PA

NPI 1861663080 · NPPES record last updated Mar 14, 2008

Key facts

NPI
1861663080
Entity type
Individual (NPI type 1)
Primary specialty
Psychologist 103T00000X
License
PS-003649-L (PA)
Practice address
606 Washington Ave
Olyphant, PA 18447-2161
Phone
(570) 489-4882
NPI assigned
Mar 14, 2008
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
PS-003649-LPAMDPsychologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS-003649-L PA Yes

Addresses

Primary practice location

606 Washington Ave
Olyphant, PA 18447-2161

Mailing address

606 Washington Ave
Olyphant, PA 18447-2161
Phone (570) 489-4882

Other providers in Olyphant, PA

All providers in Olyphant, PA · Psychologist in Pennsylvania

Sources for this page

Verify at the official NPI Registry.