Provider Demographics
NPI:1275865289
Name:SOMATIKA, LLC
Entity Type:Organization
Organization Name:SOMATIKA, LLC
Other - Org Name:MOVING THE SELF PSYCHOTHERAPY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRIZIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PALLARO
Authorized Official - Suffix:
Authorized Official - Credentials:LCMFT, BC-DMT
Authorized Official - Phone:301-390-2742
Mailing Address - Street 1:3010 MITCHELLVILLE RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-6300
Mailing Address - Country:US
Mailing Address - Phone:301-390-2742
Mailing Address - Fax:
Practice Address - Street 1:3010 MITCHELLVILLE RD
Practice Address - Street 2:SUITE 104
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-6300
Practice Address - Country:US
Practice Address - Phone:301-390-2742
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-02
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCM 162106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty