Provider Demographics
NPI:1508530692
Name:PAM SKOP MENTAL HEALTH COUNSELING LLC
Entity Type:Organization
Organization Name:PAM SKOP MENTAL HEALTH COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:SKOP
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:917-336-8691
Mailing Address - Street 1:4501 BROADWAY APT 7A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10040-2412
Mailing Address - Country:US
Mailing Address - Phone:516-526-3491
Mailing Address - Fax:
Practice Address - Street 1:4501 BROADWAY APT 7A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10040-2412
Practice Address - Country:US
Practice Address - Phone:516-526-3491
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY008651OtherNYS LICENSE NUMBER