Provider Demographics
NPI:1285678219
Name:CADE, PAMELA SUSAN (LMHC)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:SUSAN
Last Name:CADE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MS
Other - First Name:PAMELA
Other - Middle Name:SUSAN
Other - Last Name:CADE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:6299 POWERS AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32217-2287
Mailing Address - Country:US
Mailing Address - Phone:904-802-4972
Mailing Address - Fax:904-352-2292
Practice Address - Street 1:6299 POWERS AVE STE 5
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32217
Practice Address - Country:US
Practice Address - Phone:904-802-4972
Practice Address - Fax:904-352-2292
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH6301101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBCBSFOtherZ044A