| Katharine Petzold Lcsw-c Llc | |
|
3 N Harrison St Ste 206 Easton MD 21601-3146 | |
| (410) 819-2150 | |
| Not Available |
| Full Name | Katharine Petzold Lcsw-c Llc |
|---|---|
| Speciality | Social Worker |
| Location | 3 N Harrison St Ste 206, Easton, Maryland |
| Authorized Official Name and Position | Katharine Petzold (OWNER) |
| Authorized Official Contact | 4108192150 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Katharine Petzold Lcsw-c Llc 520 Trippe Ave Easton MD 21601-2521 Ph: (410) 819-2150 | Katharine Petzold Lcsw-c Llc 3 N Harrison St Ste 206 Easton MD 21601-3146 Ph: (410) 819-2150 |
| NPI Number | 1457964454 |
|---|---|
| Provider Enumeration Date | 08/28/2020 |
| Last Update Date | 09/30/2020 |
| Certification Date | 09/30/2020 |
| Medicare PECOS PAC ID | 6709203730 |
|---|---|
| Medicare Enrollment ID | O20200904000428 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457964454 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Katharine Petzold |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659874824 PECOS PAC ID: 2062839095 Enrollment ID: I20200908002879 |
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