Provider Demographics
NPI:1851937742
Name:PAWELSKI, PAMELA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:
Last Name:PAWELSKI
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 1:15025 S DES PLAINES ST
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-1801
Mailing Address - Country:US
Mailing Address - Phone:630-428-7890
Mailing Address - Fax:
Practice Address - Street 1:825 N CASS AVE STE 112
Practice Address - Street 2:
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-6401
Practice Address - Country:US
Practice Address - Phone:630-318-0012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-26
Last Update Date:2023-06-11
Deactivation Date:2020-02-03
Deactivation Code:
Reactivation Date:2020-06-25
Provider Licenses
StateLicense IDTaxonomies
IL149.0246191041C0700X
IL150.103968104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker