1184857864 NPI number — MRS. PAMELA ANN SANABRIA M.ED., LPC, NCC

Table of content: MRS. PAMELA ANN SANABRIA M.ED., LPC, NCC (NPI 1184857864)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184857864 NPI number — MRS. PAMELA ANN SANABRIA M.ED., LPC, NCC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SANABRIA
Provider First Name:
PAMELA
Provider Middle Name:
ANN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.ED., LPC, NCC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KELAHER
Provider Other First Name:
PAMELA
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.ED., LPC, NCC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1184857864
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/30/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
619 S PALMETTO WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SURFSIDE BEACH
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29575-3581
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
843-685-3081
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
671 JAMESTOWN DR
Provider Second Line Business Practice Location Address:
SUITE 202-E
Provider Business Practice Location Address City Name:
MURRELLS INLET
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29576-7507
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
843-685-3081
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/28/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  5216 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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