Provider Demographics
NPI:1942877576
Name:ENRIGHT, PAMELA ANN (LCPC)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:ANN
Last Name:ENRIGHT
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1N344 GLENRISE CT
Mailing Address - Street 2:
Mailing Address - City:GLEN ELLYN
Mailing Address - State:IL
Mailing Address - Zip Code:60137-3696
Mailing Address - Country:US
Mailing Address - Phone:630-550-8653
Mailing Address - Fax:
Practice Address - Street 1:104 E ROOSEVELT RD STE 203A
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-5200
Practice Address - Country:US
Practice Address - Phone:630-534-3179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-10
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.001404101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional