Provider Demographics
NPI:1245354497
Name:TROUTMAN, PAMELA MICHELE (LMHC CAP)
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:MICHELE
Last Name:TROUTMAN
Suffix:
Gender:F
Credentials:LMHC CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1463 OAKFIELD DR STE 125
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-0802
Mailing Address - Country:US
Mailing Address - Phone:813-624-2505
Mailing Address - Fax:866-702-6435
Practice Address - Street 1:1463 OAKFIELD DR STE 125
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-0802
Practice Address - Country:US
Practice Address - Phone:813-662-4214
Practice Address - Fax:866-702-6435
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MH81941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health