Provider Demographics
NPI:1982902292
Name:SHINDE, PALLAVI (MS)
Entity Type:Individual
Prefix:
First Name:PALLAVI
Middle Name:
Last Name:SHINDE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2030 W TILGHMAN ST
Mailing Address - Street 2:SUITE 105B
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-4354
Mailing Address - Country:US
Mailing Address - Phone:484-221-9136
Mailing Address - Fax:484-221-9130
Practice Address - Street 1:985 HORSHAM RD
Practice Address - Street 2:
Practice Address - City:NORTH WALES
Practice Address - State:PA
Practice Address - Zip Code:19454-1410
Practice Address - Country:US
Practice Address - Phone:484-221-9136
Practice Address - Fax:484-221-9130
Is Sole Proprietor?:No
Enumeration Date:2011-03-10
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0228821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical