Provider Demographics
NPI:1174042865
Name:ALLEN, PAMELA (LPC)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2415 HUNTERS CREEK CV
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-5906
Mailing Address - Country:US
Mailing Address - Phone:512-791-4426
Mailing Address - Fax:
Practice Address - Street 1:11615 ANGUS RD STE 218
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-4066
Practice Address - Country:US
Practice Address - Phone:512-492-6200
Practice Address - Fax:512-492-6200
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-13
Last Update Date:2017-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health