Provider Demographics
NPI:1679628671
Name:CLAUSEN, PAMELA MARIE (LCPC)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:MARIE
Last Name:CLAUSEN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 SW HIGGINS AVE, SUITE 206
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59803
Mailing Address - Country:US
Mailing Address - Phone:406-274-6040
Mailing Address - Fax:833-248-9203
Practice Address - Street 1:1001 SW HIGGINS AVE, SUITE 206
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59803
Practice Address - Country:US
Practice Address - Phone:406-274-6040
Practice Address - Fax:833-248-9203
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT906101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0000744732OtherBLUE CROSS BLUE SHIELD
MT0256649Medicaid