Healthcare Provider Details

I. General information

NPI: 1811810666
Provider Name (Legal Business Name): CONSTANCE W. PULLEN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 S WASHINGTON ST
EASTON MD
21601-3044
US

IV. Provider business mailing address

25800 AVONIA LN
ROYAL OAK MD
21662-1417
US

V. Phone/Fax

Practice location:
  • Phone: 410-822-6501
  • Fax:
Mailing address:
  • Phone: 410-822-6501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: CONSTANCE W. PULLEN
Title or Position: MANAGING MEMBER
Credential: LCSW-C
Phone: 410-822-6501