Provider Demographics
NPI:1619230539
Name:LLEWELLYN, PAMELA J (LCSW-C)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:J
Last Name:LLEWELLYN
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 SHELBURNE RD
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-6346
Mailing Address - Country:US
Mailing Address - Phone:410-210-4836
Mailing Address - Fax:
Practice Address - Street 1:902 SHELBURNE RD
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-6346
Practice Address - Country:US
Practice Address - Phone:410-210-4836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-18
Last Update Date:2023-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD177691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical