Provider Demographics
NPI:1346485869
Name:LAWSON, PAMELA G (LCSW, ACSW,BCD)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:G
Last Name:LAWSON
Suffix:
Gender:F
Credentials:LCSW, ACSW,BCD
Other - Prefix:MS
Other - First Name:PAMELA
Other - Middle Name:HUGHES
Other - Last Name:LAWSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW,ACSW, BCD
Mailing Address - Street 1:302 BROOKDALE DRIVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108
Mailing Address - Country:US
Mailing Address - Phone:630-307-9645
Mailing Address - Fax:
Practice Address - Street 1:302 BROOKDALE DRIVE
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108
Practice Address - Country:US
Practice Address - Phone:630-307-9645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-12
Last Update Date:2008-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490076881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical