Provider Demographics
NPI:1861483315
Name:KIRKMAN, PAMELA PARKER (LCSW MAC)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:PARKER
Last Name:KIRKMAN
Suffix:
Gender:F
Credentials:LCSW MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13105 SIR SCOTT DR
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-4753
Mailing Address - Country:US
Mailing Address - Phone:804-796-1882
Mailing Address - Fax:804-734-9601
Practice Address - Street 1:700 24TH ST
Practice Address - Street 2:SUITE D-26
Practice Address - City:FORT LEE
Practice Address - State:VA
Practice Address - Zip Code:23801-1716
Practice Address - Country:US
Practice Address - Phone:804-734-9601
Practice Address - Fax:804-734-9193
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-03
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040013311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical