Provider Demographics
NPI:1003049727
Name:DEHART, PAMELA HELEN (MA, LPC , CAC, CCDP)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:HELEN
Last Name:DEHART
Suffix:
Gender:F
Credentials:MA, LPC , CAC, CCDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 N 20TH ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-3701
Mailing Address - Country:US
Mailing Address - Phone:610-770-7558
Mailing Address - Fax:
Practice Address - Street 1:555 HARRISON ST
Practice Address - Street 2:
Practice Address - City:EMMAUS
Practice Address - State:PA
Practice Address - Zip Code:18049-2339
Practice Address - Country:US
Practice Address - Phone:610-965-6418
Practice Address - Fax:610-965-6382
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-27
Last Update Date:2009-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005001101Y00000X
PAPC005001 CAC, PCB101YA0400X
PAPC005001 CCDP, PCB101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health