Healthcare Provider Details

I. General information

NPI: 1518289420
Provider Name (Legal Business Name): PAMELA LYNN NODEN M.S., LPC, CAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/18/2010
Last Update Date: 01/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2320 ROTHSVILLE RD STE 103A
LITITZ PA
17543
US

IV. Provider business mailing address

2320 ROTHSVILLE RD STE 103A
LITITZ PA
17543-8216
US

V. Phone/Fax

Practice location:
  • Phone: 717-627-5133
  • Fax: 717-627-0052
Mailing address:
  • Phone: 717-627-5133
  • Fax: 717-627-0052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number100578
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC 004901
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: