=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245354497
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PAMELA MICHELE TROUTMAN LMHC CAP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/16/2007
-----------------------------------------------------
Last Update Date | 05/24/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1463 OAKFIELD DR STE 125
-----------------------------------------------------
City | BRANDON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33511-0802
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-662-4214
-----------------------------------------------------
Fax | 866-702-6435
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1463 OAKFIELD DR STE 125
-----------------------------------------------------
City | BRANDON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33511-0802
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-624-2505
-----------------------------------------------------
Fax | 866-702-6435
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | MH8194
-----------------------------------------------------
License Number State |
-----------------------------------------------------