Provider Demographics
NPI:1013030170
Name:LATOS, PAMELA L (MSW LCSW ACSW)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:L
Last Name:LATOS
Suffix:
Gender:F
Credentials:MSW LCSW ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1024 NORTH BLVD
Mailing Address - Street 2:SUITE 209
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60301-1169
Mailing Address - Country:US
Mailing Address - Phone:708-358-9000
Mailing Address - Fax:708-387-9451
Practice Address - Street 1:1024 NORTH BLVD
Practice Address - Street 2:SUITE 209
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301-1169
Practice Address - Country:US
Practice Address - Phone:708-358-9000
Practice Address - Fax:708-387-9451
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical