Provider Demographics
NPI:1972608198
Name:CROWE, PAMELA FLYNN (MHS, LPC)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:FLYNN
Last Name:CROWE
Suffix:
Gender:F
Credentials:MHS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 S ERWIN ST
Mailing Address - Street 2:
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30120-3502
Mailing Address - Country:US
Mailing Address - Phone:470-315-1118
Mailing Address - Fax:678-802-6797
Practice Address - Street 1:18 S ERWIN ST
Practice Address - Street 2:
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-3502
Practice Address - Country:US
Practice Address - Phone:470-315-1118
Practice Address - Fax:678-802-6797
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2992101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health