Provider Demographics
NPI:1184791675
Name:THORP, PAMELA (LCSW)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:THORP
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:MS
Other - First Name:PAMELA
Other - Middle Name:
Other - Last Name:THORP
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:303 5TH AVE RM 1503
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6666
Mailing Address - Country:US
Mailing Address - Phone:917-697-6134
Mailing Address - Fax:
Practice Address - Street 1:303 5TH AVE RM 1503
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6666
Practice Address - Country:US
Practice Address - Phone:917-697-6134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR039413-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN5B611Medicare ID - Type UnspecifiedPROVIDER ID