Provider Demographics
NPI:1659497568
Name:CLAUSEN, PAMELA A (LMHP)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:A
Last Name:CLAUSEN
Suffix:
Gender:F
Credentials:LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5858
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68802-5858
Mailing Address - Country:US
Mailing Address - Phone:308-381-7487
Mailing Address - Fax:308-381-2712
Practice Address - Street 1:3532 W CAPITAL AVE
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-1205
Practice Address - Country:US
Practice Address - Phone:308-381-7487
Practice Address - Fax:308-381-2712
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1236101YM0800X
NE759101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47077707526Medicaid