Provider Demographics
NPI:1316024987
Name:PHELPS, PAMELA DARLENE (M ED, LPC)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:DARLENE
Last Name:PHELPS
Suffix:
Gender:F
Credentials:M ED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1409 KATHY LN SW
Mailing Address - Street 2:SUITE #10
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-3656
Mailing Address - Country:US
Mailing Address - Phone:256-353-8528
Mailing Address - Fax:256-353-8529
Practice Address - Street 1:1409 KATHY LN SW
Practice Address - Street 2:SUITE #10
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-3656
Practice Address - Country:US
Practice Address - Phone:256-353-8528
Practice Address - Fax:256-353-8529
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL2111101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional