=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740732270
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PAMELA JEAN SEVERSON LMHC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/01/2016
-----------------------------------------------------
Last Update Date | 02/11/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 316 S 5TH ST
-----------------------------------------------------
City | MAQUOKETA
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 52060-2808
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 319-596-6800
-----------------------------------------------------
Fax | 319-423-6123
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 316 S 5TH ST
-----------------------------------------------------
City | MAQUOKETA
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 52060-2808
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 319-440-7317
-----------------------------------------------------
Fax | 319-423-6123
-----------------------------------------------------
=====================================================
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 | 078850
-----------------------------------------------------
License Number State | IA
-----------------------------------------------------