Provider Demographics
NPI:1568820736
Name:SMITH, PAMELA KAY (LPC)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:KAY
Last Name:SMITH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1114 WEBSTER AVE
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-5345
Mailing Address - Country:US
Mailing Address - Phone:610-739-9650
Mailing Address - Fax:
Practice Address - Street 1:1101 NORTHAMPTON ST
Practice Address - Street 2:SUITE 201
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042-4152
Practice Address - Country:US
Practice Address - Phone:610-559-8151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-03
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC010762101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty