Provider Demographics
NPI:1891011912
Name:MCINTIRE, PAMELA ELLEN (LPC)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:ELLEN
Last Name:MCINTIRE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 OLD LYNCHBURG RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-6550
Mailing Address - Country:US
Mailing Address - Phone:434-962-3827
Mailing Address - Fax:434-972-1860
Practice Address - Street 1:502 OLD LYNCHBURG RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-6550
Practice Address - Country:US
Practice Address - Phone:434-962-3827
Practice Address - Fax:434-972-1860
Is Sole Proprietor?:No
Enumeration Date:2010-04-14
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004801101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional