Provider Demographics
NPI:1902627854
Name:PILARCZYK, BRANDI NICOLE
Entity type:Individual
Prefix:
First Name:BRANDI
Middle Name:NICOLE
Last Name:PILARCZYK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1451 SUGAR CREEK CT
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46385-5388
Mailing Address - Country:US
Mailing Address - Phone:219-405-6408
Mailing Address - Fax:
Practice Address - Street 1:1451 SUGAR CREEK CT
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46385-5388
Practice Address - Country:US
Practice Address - Phone:219-405-6408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)