Provider Demographics
NPI:1992287775
Name:NADZAN, PAMELA ANN (LPC)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:ANN
Last Name:NADZAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:863 N PINE RD
Mailing Address - Street 2:
Mailing Address - City:ESSEXVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48732-2159
Mailing Address - Country:US
Mailing Address - Phone:989-778-2272
Mailing Address - Fax:989-778-2276
Practice Address - Street 1:863 N PINE RD
Practice Address - Street 2:
Practice Address - City:ESSEXVILLE
Practice Address - State:MI
Practice Address - Zip Code:48732-2159
Practice Address - Country:US
Practice Address - Phone:989-778-2272
Practice Address - Fax:989-778-2276
Is Sole Proprietor?:No
Enumeration Date:2018-08-29
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401020330101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health