Provider Demographics
NPI:1285783977
Name:STIMAC, PAMELA E (MSW)
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:E
Last Name:STIMAC
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:632 HAMPTON AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15221-3311
Mailing Address - Country:US
Mailing Address - Phone:412-243-5579
Mailing Address - Fax:
Practice Address - Street 1:1112 S BRADDOCK AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15218-1262
Practice Address - Country:US
Practice Address - Phone:412-243-4377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0138601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA659185OtherHIGHMARK PROVIDER NUMBER