Provider Demographics
NPI:1548382146
Name:PAUL, PAMELA W (LMHC)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:W
Last Name:PAUL
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2205 LAUREN DR
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33774-1504
Mailing Address - Country:US
Mailing Address - Phone:727-584-6919
Mailing Address - Fax:727-585-5573
Practice Address - Street 1:2205 LAUREN DR
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33774-1504
Practice Address - Country:US
Practice Address - Phone:727-584-6919
Practice Address - Fax:727-585-5573
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH5770101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor