Provider Demographics
NPI:1598118184
Name:WARE, PAMELA J (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:J
Last Name:WARE
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3770 PURITAN WAY UNIT E
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:CO
Mailing Address - Zip Code:80516-9463
Mailing Address - Country:US
Mailing Address - Phone:303-957-3101
Mailing Address - Fax:303-957-3113
Practice Address - Street 1:3770 PURITAN WAY UNIT E
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:CO
Practice Address - Zip Code:80516-9463
Practice Address - Country:US
Practice Address - Phone:303-957-3101
Practice Address - Fax:303-957-3113
Is Sole Proprietor?:No
Enumeration Date:2016-07-19
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW 009919651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical