Provider Demographics
NPI:1790131084
Name:SCHOTT, PAMELA (LCSW, CPM)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:SCHOTT
Suffix:
Gender:F
Credentials:LCSW, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:432 WAVERLY AVE
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-3190
Mailing Address - Country:US
Mailing Address - Phone:732-616-1773
Mailing Address - Fax:
Practice Address - Street 1:432 WAVERLY AVE
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-3190
Practice Address - Country:US
Practice Address - Phone:732-616-1773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-05
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC044084001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical