Provider Demographics
NPI:1447228424
Name:SCHUTTER, PAMELA A (LMFT)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:A
Last Name:SCHUTTER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 W TOWN PL
Mailing Address - Street 2:SUITE 205 B
Mailing Address - City:SAINT AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32092-3648
Mailing Address - Country:US
Mailing Address - Phone:904-484-2158
Mailing Address - Fax:904-571-2522
Practice Address - Street 1:475 WEST TOWN PLACE
Practice Address - Street 2:SUITE 205 B
Practice Address - City:SAINT AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32092-0116
Practice Address - Country:US
Practice Address - Phone:904-484-2158
Practice Address - Fax:904-471-2522
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-08
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT1829106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ1292OtherBCBS