Provider Demographics
NPI:1295055382
Name:MCCABE, PAMELA J (MA, LMFT)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:J
Last Name:MCCABE
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6425 NICOLLET AVE
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55423-1675
Mailing Address - Country:US
Mailing Address - Phone:612-861-1675
Mailing Address - Fax:
Practice Address - Street 1:1000 RADIO DR
Practice Address - Street 2:SUITE 210
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-8409
Practice Address - Country:US
Practice Address - Phone:651-365-8209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-11
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2151106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist