Provider Demographics
NPI:1700100484
Name:BEHNEN, PAMELA A (LPC)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:A
Last Name:BEHNEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6735 MITCHELL AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63139-3647
Mailing Address - Country:US
Mailing Address - Phone:314-488-7393
Mailing Address - Fax:314-571-9932
Practice Address - Street 1:6735 MITCHELL AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63139-3647
Practice Address - Country:US
Practice Address - Phone:314-488-7393
Practice Address - Fax:314-571-9932
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-24
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009032271101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor