Provider Demographics
NPI:1174688584
Name:DIHLE, PATRICE H (LCSW-C)
Entity type:Individual
Prefix:MS
First Name:PATRICE
Middle Name:H
Last Name:DIHLE
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:PO BOX 1174
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-0174
Mailing Address - Country:US
Mailing Address - Phone:301-695-5222
Mailing Address - Fax:301-695-5227
Practice Address - Street 1:130 THOMAS JOHNSON DR
Practice Address - Street 2:STE 3
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4584
Practice Address - Country:US
Practice Address - Phone:301-695-5222
Practice Address - Fax:301-695-5227
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD076581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDQB62Medicare UPIN
MD11247918Medicare UPIN
MD310QMedicare ID - Type Unspecified
MD026216Medicare UPIN