1609011790 NPI number — DR. PAMELA A. SCHALOW, LCP, PLLC

Table of content: (NPI 1609011790)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609011790 NPI number — DR. PAMELA A. SCHALOW, LCP, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DR. PAMELA A. SCHALOW, LCP, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1609011790
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/03/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 11804
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RICHMOND
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23230-8004
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-615-2222
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5610 GROVE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RICHMOND
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23226-2102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-615-2222
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/03/2008

Additional Information

Authorized Official

Authorized Official Last Name:
SCHALOW
Authorized Official First Name:
PAMELA
Authorized Official Middle Name:
A.
Authorized Official Title or Position:
LICENSED CLINICAL PSYCHOLOGIST
Authorized Official Telephone Number:
804-615-2222

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  0810002777 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 104562 . This is a "ANTHEM" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1952355638 . This is a "NPI FOR INDIVIDUAL PRACTITIONER" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 010053510 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 245850 . This is a "MHN/TRICARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 7610531 . This is a "AETNA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 391350 . This is a "MAMSI/OPTIMUM CHOICE/ALLIANCE PPO HEALTH PLANS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com