Healthcare Provider Details

I. General information

NPI: 1295806354
Provider Name (Legal Business Name): PAMELA NADEAU LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/12/2006
Last Update Date: 07/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 FORSTER RD
ROCHESTER MA
02770-1818
US

IV. Provider business mailing address

720 HARRISON AVE DOB 503
BOSTON MA
02118-2371
US

V. Phone/Fax

Practice location:
  • Phone: 508-763-2444
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLMHC 4563
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: