Healthcare Provider Details

I. General information

NPI: 1295771533
Provider Name (Legal Business Name): PAMELA GRACE DEVANEY PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 PARK ST SUITE 15
ANDOVER MA
01810-3662
US

IV. Provider business mailing address

511 E BROADWAY
HAVERHILL MA
01830-2401
US

V. Phone/Fax

Practice location:
  • Phone: 978-474-5004
  • Fax: 978-474-5004
Mailing address:
  • Phone: 978-373-0786
  • Fax: 978-373-0778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number7935
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number7935
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number7935
License Number StateMA
# 4
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number7935
License Number StateMA
# 5
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number7935
License Number StateMA
# 6
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number7935
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: