Provider Demographics
NPI:1841681459
Name:LINN, PAMELA (LPC)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:LINN
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 1:6535 PLACID CT
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48348
Mailing Address - Country:US
Mailing Address - Phone:810-691-0759
Mailing Address - Fax:810-591-3835
Practice Address - Street 1:501 W. FLINT ST SUITE A
Practice Address - Street 2:
Practice Address - City:DAVISON
Practice Address - State:MI
Practice Address - Zip Code:48423
Practice Address - Country:US
Practice Address - Phone:810-691-0759
Practice Address - Fax:810-591-3835
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-18
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401009394101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor