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General NPI Number Information
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NPI Number | 1134545619
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Entity Type | Individual
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Provider Name | PAMELA CRISWELL LMHC
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Gender | Female
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Dates
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Enumeration Date | 03/08/2014
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Last Update Date | 03/08/2014
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Provider Practice Location Address
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Address Line | 45 CLAPBOARDTREE ST
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City | WESTWOOD
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State | MA
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Zip | 02090-2903
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Country | US
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Telephone | 781-762-7764
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Fax |
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Provider Business Mailing Address
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Address Line | 11 ASHBROOK DR
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City | HAMPTON
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State | NH
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Zip | 03842-1002
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Country | US
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Telephone | 603-770-4765
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 4238
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License Number State | MA
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