Provider Demographics
NPI:1184010522
Name:HALFACRE, PAMELA LEA (LMSW-CC)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:LEA
Last Name:HALFACRE
Suffix:
Gender:F
Credentials:LMSW-CC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 FORE ST
Mailing Address - Street 2:APT. 1
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04101-4839
Mailing Address - Country:US
Mailing Address - Phone:207-332-1134
Mailing Address - Fax:
Practice Address - Street 1:31 FORE ST
Practice Address - Street 2:APT. 1
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-4839
Practice Address - Country:US
Practice Address - Phone:207-332-1134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-13
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC151101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical