Provider Demographics
NPI:1285919118
Name:BAKEL, PAMELA G (MS)
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:G
Last Name:BAKEL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:G
Other - Last Name:BELLOTTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:412 N PAYNE ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-2208
Mailing Address - Country:US
Mailing Address - Phone:571-275-4133
Mailing Address - Fax:
Practice Address - Street 1:212 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-3626
Practice Address - Country:US
Practice Address - Phone:571-275-4133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-11
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701006861101YP1600X, 101YP2500X, 106H00000X, 101YM0800X, 101YP1600X
IL180.009511101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist