Provider Demographics
NPI:1609011790
Name:DR. PAMELA A. SCHALOW, LCP, PLLC
Entity Type:Organization
Organization Name:DR. PAMELA A. SCHALOW, LCP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCHALOW
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:804-615-2222
Mailing Address - Street 1:PO BOX 11804
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-8004
Mailing Address - Country:US
Mailing Address - Phone:804-615-2222
Mailing Address - Fax:
Practice Address - Street 1:5610 GROVE AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-2102
Practice Address - Country:US
Practice Address - Phone:804-615-2222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-03
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810002777103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA104562OtherANTHEM
VA1952355638OtherNPI FOR INDIVIDUAL PRACTITIONER
VA010053510Medicaid
VA245850OtherMHN/TRICARE
VA7610531OtherAETNA
VA391350OtherMAMSI/OPTIMUM CHOICE/ALLIANCE PPO HEALTH PLANS
VA190001076Medicare UPIN
VA245850OtherMHN/TRICARE