Provider Demographics
NPI:1396538716
Name:GIVENS, PAMELA KAY (MFT)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:KAY
Last Name:GIVENS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6330 PRECEPT WAY
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87402-4853
Mailing Address - Country:US
Mailing Address - Phone:530-470-3015
Mailing Address - Fax:
Practice Address - Street 1:6330 PRECEPT WAY
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87402-4853
Practice Address - Country:US
Practice Address - Phone:530-470-3015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27222106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist