Healthcare Provider Details

I. General information

NPI: 1851369680
Provider Name (Legal Business Name): PAMELA RAE STEPHENS LPC, LMFT, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 12/21/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 S MAIN ST
JANESVILLE WI
53545-3922
US

IV. Provider business mailing address

1 S MAIN ST PO BOX 8010
JANESVILLE WI
53545-3922
US

V. Phone/Fax

Practice location:
  • Phone: 608-757-0404
  • Fax: 608-757-2319
Mailing address:
  • Phone: 608-757-0404
  • Fax: 608-757-2319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number420
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: