National Provider Identifier

Dylan Pakkala, LMSW

Dylan Pakkala, LMSW is listed in the NPPES registry with a primary specialty of Social Worker in Ithaca, NY and a listed phone number of (607) 274-6200.

NPI 1619734217Ithaca, NYSocial Worker

Profile Overview

NPI
1619734217
Provider Type
Individual
Primary Specialty
Social Worker
Enumeration Date
March 01, 2024
Last Updated
June 14, 2024

Practice Location

  • 201 E Green St
  • Ithaca, NY 14850-5635

Phone: (607) 274-6200

Specialties

  • Social Worker (104100000X)
  • Social Worker (104100000X)
Full Record
NPI
1619734217
Entity Type
Individual
Last Name
Pakkala
First Name
Dylan
Name Prefix
Mr.
Credential
LMSW
Mailing Street Address
201 E Green St
Mailing City
Ithaca
Mailing State
NY
Mailing ZIP Code
14850-5635
Mailing Country
US
Mailing Phone
(607) 274-6200
Practice Street Address
201 E Green St
Practice City
Ithaca
Practice State
NY
Practice ZIP Code
14850-5635
Practice Country
US
Practice Phone
(607) 274-6200
Enumeration Date
March 01, 2024
Last Updated
June 14, 2024
Sex
Male
Sole Proprietor
No
Certification Date
June 14, 2024
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Social Worker (104100000X), Social Worker (104100000X)