Healthcare Provider Details

I. General information

NPI: 1356671333
Provider Name (Legal Business Name): NANCY F. PINES SOCIAL WORKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2010
Last Update Date: 01/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 WOODBINE ST
CHEVY CHASE MD
20815-4957
US

IV. Provider business mailing address

3800 WOODBINE ST
CHEVY CHASE MD
20815-4957
US

V. Phone/Fax

Practice location:
  • Phone: 301-718-5112
  • Fax: 301-718-5112
Mailing address:
  • Phone: 301-718-5112
  • Fax: 301-718-5112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number03841
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: