Provider Demographics
NPI:1861024838
Name:PANTALINO, JUDITH BENEDICT (LPCMH)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:BENEDICT
Last Name:PANTALINO
Suffix:
Gender:F
Credentials:LPCMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5204 CENTER TER
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19802-1749
Mailing Address - Country:US
Mailing Address - Phone:302-547-8388
Mailing Address - Fax:
Practice Address - Street 1:950 LIBRARY AVENUE
Practice Address - Street 2:SUITE 104
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711
Practice Address - Country:US
Practice Address - Phone:302-724-6662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-07
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC-0000827101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health