Provider Demographics
NPI:1689246068
Name:TRIPSAS, PAMELA LITTLE (LCSW)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:LITTLE
Last Name:TRIPSAS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:ORADELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07649-2112
Mailing Address - Country:US
Mailing Address - Phone:201-926-3357
Mailing Address - Fax:
Practice Address - Street 1:327 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:ORADELL
Practice Address - State:NJ
Practice Address - Zip Code:07649-2112
Practice Address - Country:US
Practice Address - Phone:201-926-3357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0884591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty