Provider Demographics
NPI:1699836890
Name:PARVIN, PAMELA (LCPC)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:PARVIN
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 1:226 NORWAY DRIVE
Mailing Address - Street 2:
Mailing Address - City:BAR HARBOR
Mailing Address - State:ME
Mailing Address - Zip Code:04609
Mailing Address - Country:US
Mailing Address - Phone:207-288-5344
Mailing Address - Fax:
Practice Address - Street 1:61 B COTTAGE STREET
Practice Address - Street 2:
Practice Address - City:BAR HARBOR
Practice Address - State:ME
Practice Address - Zip Code:04609
Practice Address - Country:US
Practice Address - Phone:207-288-5344
Practice Address - Fax:207-288-5886
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC1703101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional