Healthcare Provider Details

I. General information

NPI: 1104800325
Provider Name (Legal Business Name): PATRICIA LOUISE ALFIN LCSW C
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/01/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6525 N CHARLES ST SUITE 33
TOWSON MD
21204-6872
US

IV. Provider business mailing address

6525 N CHARLES ST SUITE 33
TOWSON MD
21204-6872
US

V. Phone/Fax

Practice location:
  • Phone: 410-938-8456
  • Fax: 410-825-7105
Mailing address:
  • Phone: 410-938-8456
  • Fax: 410-825-7105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberMD05892
License Number StateMD

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierR1590001
Identifier TypeOTHER
Identifier State
Identifier IssuerFEP

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: