Provider Demographics
NPI:1750666574
Name:CHADWICK, PAMELA MARIE (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:MARIE
Last Name:CHADWICK
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MISS
Other - First Name:PAMELA
Other - Middle Name:MARIE
Other - Last Name:COOPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:287 S UNION ST
Mailing Address - Street 2:
Mailing Address - City:SPENCERPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14559-1401
Mailing Address - Country:US
Mailing Address - Phone:585-771-0347
Mailing Address - Fax:
Practice Address - Street 1:287 S UNION ST
Practice Address - Street 2:
Practice Address - City:SPENCERPORT
Practice Address - State:NY
Practice Address - Zip Code:14559-1401
Practice Address - Country:US
Practice Address - Phone:585-771-0347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-12
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY081406-11041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool