Provider Demographics
NPI:1639638737
Name:NEUMANN, PAMELA SUE (LSW)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:SUE
Last Name:NEUMANN
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:MS
Other - First Name:PAMELA
Other - Middle Name:SUE
Other - Last Name:MELLINO/JENKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:24306 KNICKERBOCKER WOODS
Mailing Address - Street 2:
Mailing Address - City:BAY VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44140-2821
Mailing Address - Country:US
Mailing Address - Phone:440-897-8563
Mailing Address - Fax:
Practice Address - Street 1:24306 KNICKERBOCKER WOODS
Practice Address - Street 2:
Practice Address - City:BAY VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44140-2821
Practice Address - Country:US
Practice Address - Phone:440-897-8563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-18
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
S.0901316104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker