Provider Demographics
NPI:1922762632
Name:GONZALEZ, PAMELA MERCED (MS, LMFT)
Entity Type:Individual
Prefix:MISS
First Name:PAMELA
Middle Name:MERCED
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1911
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-1912
Mailing Address - Country:US
Mailing Address - Phone:620-287-6152
Mailing Address - Fax:
Practice Address - Street 1:801 N MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-5436
Practice Address - Country:US
Practice Address - Phone:620-287-6152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-28
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS03270101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health