Provider Demographics
NPI:1558919878
Name:PAMELA L BEGAY PSYCHOTHERAPY, LLC
Entity Type:Organization
Organization Name:PAMELA L BEGAY PSYCHOTHERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:LYNETTE
Authorized Official - Last Name:BEGAY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:505-860-4253
Mailing Address - Street 1:2529 RIO VISTA WAY
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87401-4562
Mailing Address - Country:US
Mailing Address - Phone:505-860-4253
Mailing Address - Fax:
Practice Address - Street 1:5101 COLLEGE BLVD
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87402-4709
Practice Address - Country:US
Practice Address - Phone:505-608-4107
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-29
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty