Provider Demographics
NPI:1245489319
Name:LUCE-MARINE, PAMELA JEAN (LPCC)
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:JEAN
Last Name:LUCE-MARINE
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:JB
Other - Last Name:LUCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2825 ANTIOCH RD
Mailing Address - Street 2:SHELBY COUNSELING ASSOCIATES, PSC
Mailing Address - City:SHELBYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40065
Mailing Address - Country:US
Mailing Address - Phone:502-254-8880
Mailing Address - Fax:502-254-8870
Practice Address - Street 1:12701 TOWNEPARK WAY
Practice Address - Street 2:BARKLEY BLDG, SUITE 200
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40243
Practice Address - Country:US
Practice Address - Phone:502-254-8880
Practice Address - Fax:502-254-8870
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-15
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY101YP2500X
KY104161101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional