Provider Demographics
NPI:1104693183
Name:HEMINGWAY, PAMELA MARIE (LMFT)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:MARIE
Last Name:HEMINGWAY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 SILVER SANDS RD UNIT 1001
Mailing Address - Street 2:
Mailing Address - City:EAST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06512-4601
Mailing Address - Country:US
Mailing Address - Phone:860-416-1205
Mailing Address - Fax:
Practice Address - Street 1:214 AMITY RD STE C
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:CT
Practice Address - Zip Code:06525-2241
Practice Address - Country:US
Practice Address - Phone:475-434-0037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-08
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3158106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist