Individual provider Active NPI

Patrizia Pallaro, LCMFT

  • Marriage & Family Therapist
  • Annapolis, MD
National Provider Identifier
1104995067
Registry record updated Nov 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LCM162 Issued in MD
Practice address
1125 West St Ste 613
Annapolis, MD 21401-4198
Phone
(301) 390-2742
NPI assigned
Nov 7, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 25, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LCM162 MD Primary

Addresses

Primary practice location

1125 West St Ste 613
Annapolis, MD 21401-4198

Mailing address

1125 West St Ste 613
Annapolis, MD 21401-4198
Phone (301) 390-2742

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LCM162MDMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Somatika, LLC Marriage & Family Therapist CurrentSince Jun 23, 2024 Accepting new patients

Locations

1125 West St
Ste 613
Annapolis, MD 21401
Phone (301) 390-2742

3010 Mitchellville Rd
Ste 104
Bowie, MD 20716
Phone (202) 210-9425

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606262400000",
    "number": "1104995067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 WEST ST STE 613",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214014198",
            "telephone_number": "301-390-2742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 WEST ST STE 613",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214014198",
            "telephone_number": "301-390-2742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALLARO",
        "first_name": "PATRIZIA",
        "credential": "LCMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MD",
            "license": "LCM162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.