Healthcare Provider Details

I. General information

NPI: 1275651671
Provider Name (Legal Business Name): PAMELA KEAR LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 04/21/2022
Certification Date: 04/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 WASHINGTON AVE STE 201-220
SANTA FE NM
87501-2073
US

IV. Provider business mailing address

8816 YANKEE DR NE
ALBUQUERQUE NM
87109-5159
US

V. Phone/Fax

Practice location:
  • Phone: 866-949-0108
  • Fax:
Mailing address:
  • Phone: 505-264-1401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-20255
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberI-4202
License Number StateNM
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC-4202
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: