Provider Demographics
NPI:1679624035
Name:HUNT, PAMELA SKEETER (MA, LSW, LPC-S)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:SKEETER
Last Name:HUNT
Suffix:
Gender:F
Credentials:MA, LSW, LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 S MAIN ST
Mailing Address - Street 2:218
Mailing Address - City:BOWLING GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:43402-2947
Mailing Address - Country:US
Mailing Address - Phone:419-354-2464
Mailing Address - Fax:419-354-2465
Practice Address - Street 1:130 S MAIN ST
Practice Address - Street 2:218
Practice Address - City:BOWLING GREEN
Practice Address - State:OH
Practice Address - Zip Code:43402-2947
Practice Address - Country:US
Practice Address - Phone:419-354-2464
Practice Address - Fax:419-354-2465
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-14
Last Update Date:2007-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC0005903101YM0800X
OHS0020096104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH11205887OtherCAQH
OHHUSW29831Medicare PIN