Provider Demographics
NPI:1891870028
Name:WALKIEWICZ, PAMELA T (MS, LPC, NCC)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:T
Last Name:WALKIEWICZ
Suffix:
Gender:F
Credentials:MS, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2868 ACTON ROAD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35243-2502
Mailing Address - Country:US
Mailing Address - Phone:205-968-8360
Mailing Address - Fax:205-968-8361
Practice Address - Street 1:450 LANIER RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-1866
Practice Address - Country:US
Practice Address - Phone:256-774-4500
Practice Address - Fax:256-774-4573
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2650101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional