Emily E Pavlick, LCSW-C

Individual provider Active NPI Clinical Social Worker · Poolesville, MD

NPI 1962060145 · NPPES record last updated Aug 20, 2021

Key facts

NPI
1962060145
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
24837 (MD)
Practice address
18008 Bliss Dr
Poolesville, MD 20837-2401
Phone
(301) 793-9915
NPI assigned
Jun 3, 2019
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
24837MDMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Bewell Community Health, Inc. Clinical Current Accepting new patients
Bewell Therapy Group, LLC Current
since Aug 28, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 24837 MD
Clinical Social Worker 1041C0700X 24837 MD Yes

Addresses

Primary practice location

18008 Bliss Dr
Poolesville, MD 20837-2401

Mailing address

18008 Bliss Dr
Poolesville, MD 20837-2401
Phone (301) 793-9915

Other identifiers

IdentifierTypeStateIssuer
889066800MedicaidMD

Other providers in Poolesville, MD

All providers in Poolesville, MD · Clinical Social Worker in Maryland

Sources for this page

Verify at the official NPI Registry.