Provider Demographics
NPI:1912097320
Name:HAGUES, PAMELA DICKINSON (MS ED)
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:DICKINSON
Last Name:HAGUES
Suffix:
Gender:
Credentials:MS ED
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:D
Other - Last Name:HAGUES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC, CSOTP, CC
Mailing Address - Street 1:5460 AFTON OVERLOOK
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23227-2600
Mailing Address - Country:US
Mailing Address - Phone:804-601-1406
Mailing Address - Fax:804-587-7230
Practice Address - Street 1:5460 AFTON OVERLOOK
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23227-2600
Practice Address - Country:US
Practice Address - Phone:804-601-1406
Practice Address - Fax:804-587-7230
Is Sole Proprietor?:No
Enumeration Date:2006-10-14
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003605101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA10079535Medicaid