Provider Demographics
NPI:1356484521
Name:SAYRE, PAMELA J (LCSW)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:J
Last Name:SAYRE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:357 WHITNEY AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-2364
Mailing Address - Country:US
Mailing Address - Phone:203-785-0606
Mailing Address - Fax:203-785-0606
Practice Address - Street 1:357 WHITNEY AVE
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-2364
Practice Address - Country:US
Practice Address - Phone:203-785-0606
Practice Address - Fax:203-785-0606
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0029481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical