Provider Demographics
NPI:1982895710
Name:ROCKWELL, PAMELA KAYE (LPCC)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:KAYE
Last Name:ROCKWELL
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:754 LAKEWAY DR
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:KY
Mailing Address - Zip Code:42071-5645
Mailing Address - Country:US
Mailing Address - Phone:270-436-2279
Mailing Address - Fax:270-436-2279
Practice Address - Street 1:503 POPLAR ST
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-2541
Practice Address - Country:US
Practice Address - Phone:270-753-2757
Practice Address - Fax:270-753-2757
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-0905101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health