Provider Demographics
NPI:1194254029
Name:JEREMIAS, PAMELA ANN (LLMSW)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:ANN
Last Name:JEREMIAS
Suffix:
Gender:
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16919 MARY WOOD DR
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48042-2937
Mailing Address - Country:US
Mailing Address - Phone:248-912-7386
Mailing Address - Fax:
Practice Address - Street 1:2399 WALTON BLVD
Practice Address - Street 2:
Practice Address - City:AUBURN HILLS
Practice Address - State:MI
Practice Address - Zip Code:48326
Practice Address - Country:US
Practice Address - Phone:248-451-2940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-05
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801108384104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker