Provider Demographics
NPI:1962066654
Name:HOWARD, PAMELA (MA, LPC)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:HOWARD
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:BASALT
Mailing Address - State:CO
Mailing Address - Zip Code:81621-9249
Mailing Address - Country:US
Mailing Address - Phone:860-798-9406
Mailing Address - Fax:
Practice Address - Street 1:535 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:BASALT
Practice Address - State:CO
Practice Address - Zip Code:81621-9249
Practice Address - Country:US
Practice Address - Phone:860-798-9406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-28
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO00006487101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional