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General NPI Number Information
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NPI Number | 1275590226
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Entity Type | Individual
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Provider Name | PAMELA J. HIRN MS, LCSW, LPC, CSAC
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Gender | Female
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Dates
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Enumeration Date | 04/26/2006
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Last Update Date | 05/12/2016
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Provider Practice Location Address
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Address Line | 421 NEBRASKA ST
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City | STURGEON BAY
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State | WI
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Zip | 54235-2225
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Country | US
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Telephone | 920-746-7155
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Fax | 920-746-2439
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Provider Business Mailing Address
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Address Line | 421 NEBRASKA ST
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City | STURGEON BAY
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State | WI
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Zip | 54235-2225
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Country | US
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Telephone | 920-746-7155
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Fax | 920-746-2439
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 865-123
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 1749-125
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 15519-132
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License Number State | WI
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