Healthcare Provider Details

I. General information

NPI: 1487129136
Provider Name (Legal Business Name): MONIQUE DIPASALEGNE LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2018
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

518 S CAMP MEADE RD STE 4
LINTHICUM HEIGHTS MD
21090-2766
US

IV. Provider business mailing address

5 N BELLE GROVE RD
CATONSVILLE MD
21228-2050
US

V. Phone/Fax

Practice location:
  • Phone: 240-230-6109
  • Fax:
Mailing address:
  • Phone: 973-687-8899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number27923
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: