MEDICARE: PAMELA SUE HYLES LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	6801083105	MI
2	104100000X	Social Worker	6801083105	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	6801083105	OTHER	MI	SOCIAL WORK
2	H420676778881	OTHER	MI	DRIVERS LICENSE
3	14326290	OTHER	MI	CAQH

General Provider Information

NPI Number	:	1326522483
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAMELA SUE HYLES LMSW

Provider Business Mailing Address
First Line	:	3701 BEECHER RD
Second Line	:
City	:	FLINT
State	:	MI
Zip	:	48503-4974
Country	:	US
Telephone Number	:	248-390-9693
Fax Number	:

Provider Business Practice Location Address
First Line	:	6199 MILLER RD STE A
Second Line	:
City	:	SWARTZ CREEK
State	:	MI
Zip	:	48473-1585
Country	:	US
Telephone Number	:	248-390-9693
Fax Number	:	810-630-0962

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/24/2018
Last Update Date	:	01/06/2025

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