Provider Demographics
NPI:1689910366
Name:KING, PAMELA (LPC, LMFT)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:
Last Name:KING
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2131 ENCINO LOOP
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-1902
Mailing Address - Country:US
Mailing Address - Phone:210-885-5009
Mailing Address - Fax:210-497-0822
Practice Address - Street 1:1015 CENTRAL PARKWAY NORTH
Practice Address - Street 2:SUITE 145
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232
Practice Address - Country:US
Practice Address - Phone:210-885-5009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-27
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67858101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional