Provider Demographics
NPI:1316290174
Name:HARRIGAN, PAMELA JEAN (LCPC)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:JEAN
Last Name:HARRIGAN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3090 PEBBLE BEACH DR
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-2184
Mailing Address - Country:US
Mailing Address - Phone:410-599-3834
Mailing Address - Fax:
Practice Address - Street 1:8940 ROUTE 108
Practice Address - Street 2:SUITE E
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-2129
Practice Address - Country:US
Practice Address - Phone:410-599-3834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-17
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC4645101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional