Provider Demographics
NPI:1376112516
Name:PIMIENTA, MONICA G
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:G
Last Name:PIMIENTA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7077 WOODMONT AVE APT 301
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20815-6294
Mailing Address - Country:US
Mailing Address - Phone:305-799-7630
Mailing Address - Fax:
Practice Address - Street 1:2092 GAITHER RD STE 100
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-4016
Practice Address - Country:US
Practice Address - Phone:301-424-5200
Practice Address - Fax:301-424-8063
Is Sole Proprietor?:No
Enumeration Date:2021-06-22
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA0589101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor