Provider Demographics
NPI:1467874099
Name:KAYANAN, PAMELA (LPC, LMFT, LSATP)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:KAYANAN
Suffix:
Gender:F
Credentials:LPC, LMFT, LSATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 CAPITOL LANDING ROAD
Mailing Address - Street 2:COLONIAL BEHAVIORAL HEALTH
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185
Mailing Address - Country:US
Mailing Address - Phone:757-253-4074
Mailing Address - Fax:757-253-4018
Practice Address - Street 1:921 CAPITOL LANDING ROAD
Practice Address - Street 2:COLONIAL BEHAVIORAL HEALTH
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185
Practice Address - Country:US
Practice Address - Phone:757-253-4074
Practice Address - Fax:757-253-4018
Is Sole Proprietor?:No
Enumeration Date:2014-01-16
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0718000195101YA0400X
VA0701003183101YM0800X
VA0717001073106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist