Basic Information
Provider Information
NPI: 1376029694
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PINKHAM
FirstName: KATRIN
MiddleName: HUNT
NamePrefix: MS.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7474 GREENWAY CENTER DR STE 730
Address2:  
City: GREENBELT
State: MD
PostalCode: 207703523
CountryCode: US
TelephoneNumber: 3016451022
FaxNumber: 3015605558
Practice Location
Address1: 7474 GREENWAY CENTER DR STE 730
Address2:  
City: GREENBELT
State: MD
PostalCode: 207703523
CountryCode: US
TelephoneNumber: 3016451022
FaxNumber: 3015605558
Other Information
ProviderEnumerationDate: 07/19/2018
LastUpdateDate: 07/19/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
104100000X  Y Behavioral Health & Social Service ProvidersSocial Worker 

No ID Information.


Home