Provider Demographics
NPI:1730267873
Name:MUXWORTHY, PAMELA B (LMSW, CASAC)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:B
Last Name:MUXWORTHY
Suffix:
Gender:F
Credentials:LMSW, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5565 VARDON DR
Mailing Address - Street 2:
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-8860
Mailing Address - Country:US
Mailing Address - Phone:585-394-6180
Mailing Address - Fax:585-394-6180
Practice Address - Street 1:5565 VARDON DR
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-8860
Practice Address - Country:US
Practice Address - Phone:585-394-6180
Practice Address - Fax:585-394-6180
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY9625101YA0400X
NY057907-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical