Provider Demographics
NPI:1417377367
Name:CASTELLANOS, PAMELA MARIE (LPC, LPCC)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:MARIE
Last Name:CASTELLANOS
Suffix:
Gender:F
Credentials:LPC, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 N DOBSON RD
Mailing Address - Street 2:BLDG. C
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-9601
Mailing Address - Country:US
Mailing Address - Phone:480-447-6474
Mailing Address - Fax:
Practice Address - Street 1:3200 N DOBSON RD
Practice Address - Street 2:BLDG. C
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224
Practice Address - Country:US
Practice Address - Phone:480-447-6474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-18
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1200196101Y00000X
AZLPC-16214101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor