Provider Demographics
NPI:1679693691
Name:LOW, PAMELA (LCMHC MLADC)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:LOW
Suffix:
Gender:F
Credentials:LCMHC MLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 WASHINGTON ST
Mailing Address - Street 2:SUITE 12
Mailing Address - City:CONWAY
Mailing Address - State:NH
Mailing Address - Zip Code:03818-6031
Mailing Address - Country:US
Mailing Address - Phone:603-447-7046
Mailing Address - Fax:603-447-7046
Practice Address - Street 1:45 WASHINGTON ST
Practice Address - Street 2:SUITE 12
Practice Address - City:CONWAY
Practice Address - State:NH
Practice Address - Zip Code:03818-6031
Practice Address - Country:US
Practice Address - Phone:603-447-7046
Practice Address - Fax:603-447-7046
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-31
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH569101YA0400X
MELC4069101YA0400X
NH525101YM0800X
MECC3254101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
2055204OtherCIGNA
NH30426846Medicaid
NH24Y013824NH01OtherANTHEM BC BS
513326567OtherUNITED BEHAVIORAL HEALTH
21970YMedicare UPIN