Provider Demographics
NPI:1972996049
Name:LAPE, PAMELA
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:LAPE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06412-1118
Mailing Address - Country:US
Mailing Address - Phone:203-957-2249
Mailing Address - Fax:
Practice Address - Street 1:15 NORTH MAIN STREET
Practice Address - Street 2:REFLECTIONS OF CHESTER
Practice Address - City:CHESTER
Practice Address - State:CT
Practice Address - Zip Code:06412
Practice Address - Country:US
Practice Address - Phone:203-957-2249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-12
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
102L00000X
NY000647-1103TP0814X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst