Provider Demographics
NPI:1457543597
Name:CRAIG, PAMELA RENEE (MA, LPC)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:RENEE
Last Name:CRAIG
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:RENEE
Other - Last Name:KESSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:211 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:CO
Mailing Address - Zip Code:80751-3168
Mailing Address - Country:US
Mailing Address - Phone:970-522-4549
Mailing Address - Fax:970-522-4211
Practice Address - Street 1:650 E WALNUT, UNIT C
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:CO
Practice Address - Zip Code:80701
Practice Address - Country:US
Practice Address - Phone:303-646-4519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-13
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC-1823101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional