Provider Demographics
NPI:1124360904
Name:BAYES, PAMELA (LBSW)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:BAYES
Suffix:
Gender:F
Credentials:LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 FULTON ST
Mailing Address - Street 2:
Mailing Address - City:GRAND HAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:49417-1569
Mailing Address - Country:US
Mailing Address - Phone:616-846-8238
Mailing Address - Fax:
Practice Address - Street 1:1111 FULTON ST
Practice Address - Street 2:
Practice Address - City:GRAND HAVEN
Practice Address - State:MI
Practice Address - Zip Code:49417-1569
Practice Address - Country:US
Practice Address - Phone:616-846-8238
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-20
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6802078420171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator