Provider Demographics
NPI:1518289420
Name:NODEN, PAMELA LYNN (MS, LPC, CAC)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:LYNN
Last Name:NODEN
Suffix:
Gender:F
Credentials:MS, LPC, CAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2320 ROTHSVILLE RD STE 103A
Mailing Address - Street 2:
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543-8216
Mailing Address - Country:US
Mailing Address - Phone:717-627-5133
Mailing Address - Fax:717-627-0052
Practice Address - Street 1:2320 ROTHSVILLE RD STE 103A
Practice Address - Street 2:
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543
Practice Address - Country:US
Practice Address - Phone:717-627-5133
Practice Address - Fax:717-627-0052
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-18
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA100578101YA0400X
PAPC 004901101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)