Provider Demographics
NPI:1013023845
Name:CAMBARDELLA, PAMELA D (LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:D
Last Name:CAMBARDELLA
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6602 CHURCH HILL RD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:CHESTERTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21620-2310
Mailing Address - Country:US
Mailing Address - Phone:410-778-5550
Mailing Address - Fax:410-778-0984
Practice Address - Street 1:6602 CHURCH HILL RD
Practice Address - Street 2:SUITE 500
Practice Address - City:CHESTERTOWN
Practice Address - State:MD
Practice Address - Zip Code:21620-2310
Practice Address - Country:US
Practice Address - Phone:410-778-5550
Practice Address - Fax:410-778-0984
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD025711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD121974OtherAMERICAN PSYCH SYSTEM #
MD31153OtherJOHNS HOPKINS ID#
MD5108250OtherAETNA ID#
MD720406OtherNCPPO ID#
MD62-82986OtherUBH ID#
MDLT86-0007OtherBLUE CROSS LOCAL GROUP #
MD32839OtherMAMSI GROUP#
MD1004274OtherCIGNA HEALTHCARE ID#
MD180830OtherHEALTHNET/TRICARE ID#
MD00903OtherVALUE OPTIONS ID#
MDT418-0007OtherBLUE CROSS NAT GROUP #
MD720406OtherNCPPO ID#