Provider Demographics
NPI:1326160573
Name:DEHKES, PAMELA LEIGH (LICSW)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:LEIGH
Last Name:DEHKES
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 FLORIDA AVE S STE 307
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55426-1759
Mailing Address - Country:US
Mailing Address - Phone:952-544-6806
Mailing Address - Fax:952-545-0098
Practice Address - Street 1:715 FLORIDA AVE S
Practice Address - Street 2:SUITE 307
Practice Address - City:ST. LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55426
Practice Address - Country:US
Practice Address - Phone:952-544-6806
Practice Address - Fax:952-545-0098
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN15432104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker