Provider Demographics
NPI:1457491748
Name:LESEMANN, PAMELA (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:LESEMANN
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2831 RINGLING BLVD
Mailing Address - Street 2:#C206
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34237-5334
Mailing Address - Country:US
Mailing Address - Phone:941-366-4607
Mailing Address - Fax:
Practice Address - Street 1:2831 RINGLING BLVD
Practice Address - Street 2:#C206
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237-5334
Practice Address - Country:US
Practice Address - Phone:941-366-4607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH0002052101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health