Provider Demographics
NPI:1538895479
Name:HILINSKI-WETZEL, MALLORY ELIZABETH (MS, LPC, NCC)
Entity type:Individual
Prefix:
First Name:MALLORY
Middle Name:ELIZABETH
Last Name:HILINSKI-WETZEL
Suffix:
Gender:F
Credentials:MS, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 55207
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98155-0207
Mailing Address - Country:US
Mailing Address - Phone:425-894-4083
Mailing Address - Fax:
Practice Address - Street 1:322 N SHORE DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-5875
Practice Address - Country:US
Practice Address - Phone:425-600-6425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-25
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC14639101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional