Provider Demographics
NPI:1568713642
Name:CHILDS, PAMELA VALLETT (LPC/MHSP)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:VALLETT
Last Name:CHILDS
Suffix:
Gender:F
Credentials:LPC/MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1264 FOSTER AVENUE
Mailing Address - Street 2:NASHVILLE CHILDREN'S ALLIANCE
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37210-1646
Mailing Address - Country:US
Mailing Address - Phone:615-327-9958
Mailing Address - Fax:615-327-9896
Practice Address - Street 1:1264 FOSTER AVENUE
Practice Address - Street 2:NASHVILLE CHILDREN'S ALLIANCE
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37210-1646
Practice Address - Country:US
Practice Address - Phone:615-327-9958
Practice Address - Fax:615-327-9896
Is Sole Proprietor?:No
Enumeration Date:2012-09-28
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC0000001952101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional