Provider Demographics
NPI:1811435076
Name:PISULA, COREY (LCSW-C)
Entity type:Individual
Prefix:
First Name:COREY
Middle Name:
Last Name:PISULA
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11912 KNOB RD NE
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-8227
Mailing Address - Country:US
Mailing Address - Phone:724-757-5159
Mailing Address - Fax:
Practice Address - Street 1:6701 DEMOCRACY BLVD STE 300
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-7500
Practice Address - Country:US
Practice Address - Phone:646-941-7645
Practice Address - Fax:929-596-7897
Is Sole Proprietor?:No
Enumeration Date:2017-02-08
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15804104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker