Individual
KIMBERLY ANN MARIE PISARCIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1 TARLETON AVE, SUITE 3, DALLAS, PA 18612-1248
(570) 310-1214
(570) 310-1214
Mailing address
1 TARLETON AVE, SUITE 3, DALLAS, PA 18612-1248
(570) 310-1214
(570) 310-1273
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW016884
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1025703090004
—
PA
Enumeration date
01/31/2011
Last updated
06/25/2019
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