Provider Demographics
NPI:1932238839
Name:PRAZAN, PAMELA (LMHP)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:
Last Name:PRAZAN
Suffix:
Gender:F
Credentials:LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 34367
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134-0367
Mailing Address - Country:US
Mailing Address - Phone:402-682-9694
Mailing Address - Fax:402-682-9678
Practice Address - Street 1:2211 PEOPLES RD
Practice Address - Street 2:SUITE 1
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68005-4670
Practice Address - Country:US
Practice Address - Phone:402-682-9694
Practice Address - Fax:402-682-9678
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE15651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE84866OtherBLUE CROSS BLUE SHEILD