Provider Demographics
NPI:1730840919
Name:ANGEL, PAMELA (MA LPC)
Entity type:Individual
Prefix:MISS
First Name:PAMELA
Middle Name:
Last Name:ANGEL
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5413 BELLE MEADE DR
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:OH
Mailing Address - Zip Code:45103-8550
Mailing Address - Country:US
Mailing Address - Phone:513-268-6826
Mailing Address - Fax:
Practice Address - Street 1:7750 MONTGOMERY RD STE 110
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-4257
Practice Address - Country:US
Practice Address - Phone:513-268-6826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional