Provider Demographics
NPI:1689754038
Name:DILDINE, SIGRID (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SIGRID
Middle Name:
Last Name:DILDINE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6301 OWEN PL
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-5461
Mailing Address - Country:US
Mailing Address - Phone:301-299-2477
Mailing Address - Fax:301-933-7087
Practice Address - Street 1:6301 OWEN PL
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-5461
Practice Address - Country:US
Practice Address - Phone:301-299-2477
Practice Address - Fax:301-933-7087
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD08475104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD490276Medicare PIN