Provider Demographics
NPI:1104294628
Name:WISNIEWSKI, HILLARY MARIE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:HILLARY
Middle Name:MARIE
Last Name:WISNIEWSKI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:529 BOUQUIN CIR
Mailing Address - Street 2:
Mailing Address - City:OIL CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16301-3070
Mailing Address - Country:US
Mailing Address - Phone:814-657-2486
Mailing Address - Fax:
Practice Address - Street 1:529 BOUQUIN CIR
Practice Address - Street 2:
Practice Address - City:OIL CITY
Practice Address - State:PA
Practice Address - Zip Code:16301-3070
Practice Address - Country:US
Practice Address - Phone:814-657-2486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-15
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0202981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103070790Medicaid