Provider Demographics
NPI:1932293669
Name:UNGER, PAMELA M (PCC)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:M
Last Name:UNGER
Suffix:
Gender:F
Credentials:PCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 OUTERBELT ST.
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213
Mailing Address - Country:US
Mailing Address - Phone:614-751-5393
Mailing Address - Fax:614-751-5394
Practice Address - Street 1:100 OUTERBELT ST.
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213
Practice Address - Country:US
Practice Address - Phone:614-751-5393
Practice Address - Fax:614-751-5394
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHEOOO1566101YM0800X
OHE1566101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1908-01OtherMOUNT CARMEL BEH HLTH
OH9111115Medicaid
OH000000117280OtherANTHEM
OH174348000OtherMAGELLAN