Provider Demographics
NPI:1104036995
Name:ECREMENT, PAMELA ANN (LPCC-S, IMFT)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:ANN
Last Name:ECREMENT
Suffix:
Gender:F
Credentials:LPCC-S, IMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12322 GARNELL ST NW
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44647-9518
Mailing Address - Country:US
Mailing Address - Phone:330-265-7936
Mailing Address - Fax:
Practice Address - Street 1:1650 DIAGONAL RD
Practice Address - Street 2:THE HOUSE OF THE LORD
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-4002
Practice Address - Country:US
Practice Address - Phone:330-864-9073
Practice Address - Fax:330-864-1617
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE 0001934101YP2500X
OHF 0000130106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist