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General NPI Number Information
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NPI Number | 1710283304
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Entity Type | Individual
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Provider Name | KIMBERLY ANN MARIE PISARCIK LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/31/2011
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Last Update Date | 06/25/2019
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Provider Practice Location Address
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Address Line | 1 TARLETON AVE SUITE 3
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City | DALLAS
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State | PA
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Zip | 18612-1248
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Country | US
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Telephone | 570-310-1214
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Fax | 570-310-1214
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Provider Business Mailing Address
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Address Line | 1 TARLETON AVE SUITE 3
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City | DALLAS
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State | PA
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Zip | 18612-1248
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Country | US
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Telephone | 570-310-1214
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Fax | 570-310-1273
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW016884
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License Number State | PA
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