1194995456 NPI number — MS. PAMELA ANN PATEY WEEG LCPC, PMHNP-BC

Table of content: MS. PAMELA ANN PATEY WEEG LCPC, PMHNP-BC (NPI 1194995456)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194995456 NPI number — MS. PAMELA ANN PATEY WEEG LCPC, PMHNP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WEEG
Provider First Name:
PAMELA
Provider Middle Name:
ANN PATEY
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LCPC, PMHNP-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PATEY
Provider Other First Name:
PAMELA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCPC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1194995456
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/03/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
711 BURNING TREE CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SALISBURY
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21801-7001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-920-9080
Provider Business Mailing Address Fax Number:
410-630-1654

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1411 WESLEY DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SALISBURY
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21801-7149
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-642-4011
Provider Business Practice Location Address Fax Number:
410-630-1654
Provider Enumeration Date:
03/03/2008

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:  LC3341 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X , with the licence number: R252166 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 119591300 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com