| Pamela Dipesa, Llc | |
|
711 W. 40th Street Suite 321 Baltimore MD 21211 | |
| (410) 235-2882 | |
| (410) 235-2883 |
| Full Name | Pamela Dipesa, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 711 W. 40th Street, Baltimore, Maryland |
| Authorized Official Name and Position | Pamela Dipesa (PSYCHOTHERAPIST) |
| Authorized Official Contact | 4102352882 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pamela Dipesa, Llc 711 W. 40th Street Suite 321 Baltimore MD 21211 Ph: (410) 235-2882 | Pamela Dipesa, Llc 711 W. 40th Street Suite 321 Baltimore MD 21211 Ph: (410) 235-2882 |
| NPI Number | 1255789350 |
|---|---|
| Provider Enumeration Date | 05/31/2016 |
| Last Update Date | 05/31/2016 |
| Medicare PECOS PAC ID | 7517259146 |
|---|---|
| Medicare Enrollment ID | O20160630000388 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255789350 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 11980 (Maryland) | Primary |
| Provider Name | Pamela E Dipesa |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871799189 PECOS PAC ID: 3274833397 Enrollment ID: I20151123000009 |
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