Provider Demographics
NPI:1508989658
Name:KLEESPIES, PAMELA C (LCSW)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:C
Last Name:KLEESPIES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 GAYLEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-2133
Mailing Address - Country:US
Mailing Address - Phone:817-371-2718
Mailing Address - Fax:
Practice Address - Street 1:6051 DAVIS BLVD
Practice Address - Street 2:821277
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-6385
Practice Address - Country:US
Practice Address - Phone:817-851-2042
Practice Address - Fax:817-405-3364
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX42170104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker