Provider Demographics
NPI:1669752812
Name:WILLIAMS, PAMELA JO (LPC)
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:JO
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3 KENSINGTON SQ STE B
Mailing Address - Street 2:
Mailing Address - City:NEW KENSINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15068-6443
Mailing Address - Country:US
Mailing Address - Phone:724-335-9733
Mailing Address - Fax:724-335-9734
Practice Address - Street 1:3 KENSINGTON SQ STE B
Practice Address - Street 2:
Practice Address - City:NEW KENSINGTON
Practice Address - State:PA
Practice Address - Zip Code:15068-6443
Practice Address - Country:US
Practice Address - Phone:724-335-9733
Practice Address - Fax:724-335-9734
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-19
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005403101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
197961OtherHIGHMARK
PA330989OtherVBH
PA206234OtherUPMC
PA1210OtherCBHNP
PA424947OtherHEALTH AMERICA
PA1007624160014Medicaid
PA184265OtherUNISON
PAPPO7109257OtherAETNA
PAHMO2595457OtherAETNA
PA1000364OtherCCBHO