Healthcare Provider Details

I. General information

NPI: 1811064108
Provider Name (Legal Business Name): PAMELA SUSAN GEFELL M.A.,L.M.H.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5130 E MAIN STREET RD SUITE #2
BATAVIA NY
14020-3433
US

IV. Provider business mailing address

4180 RIDGE RD
ELBA NY
14058-9726
US

V. Phone/Fax

Practice location:
  • Phone: 585-344-1421
  • Fax: 585-344-3047
Mailing address:
  • Phone: 585-757-9964
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number001266
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: