MEDICARE: PAMALA ALAN MA, LPC, NCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	LPCC.0015761	CO
2	101YM0800X	Mental Health Counselor	LPC.0016848	CO

General Provider Information

NPI Number	:	1437646205
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAMALA ALAN MA, LPC, NCC

Provider Business Mailing Address
First Line	:	PO BOX 621812
Second Line	:
City	:	LITTLETON
State	:	CO
Zip	:	80162-1812
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5931 MIDDLEFIELD RD STE 100
Second Line	:
City	:	LITTLETON
State	:	CO
Zip	:	80123-2865
Country	:	US
Telephone Number	:	720-608-1008
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/17/2018
Last Update Date	:	11/04/2022

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