Provider Demographics
NPI:1215224142
Name:DUDEK, PAMELA (LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:
Last Name:DUDEK
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 1:1320 BERNOUDY ROAD
Mailing Address - Street 2:
Mailing Address - City:WHITE HALL
Mailing Address - State:MD
Mailing Address - Zip Code:21161
Mailing Address - Country:US
Mailing Address - Phone:410-627-0780
Mailing Address - Fax:
Practice Address - Street 1:160 BAHNS MILL RD.
Practice Address - Street 2:
Practice Address - City:RED LION
Practice Address - State:PA
Practice Address - Zip Code:17356
Practice Address - Country:US
Practice Address - Phone:410-627-0780
Practice Address - Fax:410-744-4203
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD08434104100000X, 1041C0700X
PACW018977104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical