Provider Demographics
NPI:1689010993
Name:THURMAN, PAMELA JO (LPCC)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:JO
Last Name:THURMAN
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:MS
Other - First Name:PAMELA
Other - Middle Name:JO
Other - Last Name:ELLIOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:130 SOUTHERN SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42501-3223
Mailing Address - Country:US
Mailing Address - Phone:606-679-4782
Mailing Address - Fax:606-677-1746
Practice Address - Street 1:259 PARKERS MILL RD
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42501-3152
Practice Address - Country:US
Practice Address - Phone:606-679-7348
Practice Address - Fax:606-679-4097
Is Sole Proprietor?:No
Enumeration Date:2013-05-14
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY164619101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1689010993Medicaid