Provider Demographics
NPI:1245521483
Name:CASSELLIUS, PAMELA KATHERINE (MA, LPC)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:KATHERINE
Last Name:CASSELLIUS
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1630
Mailing Address - Street 2:
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28370-1630
Mailing Address - Country:US
Mailing Address - Phone:910-295-6007
Mailing Address - Fax:877-256-8588
Practice Address - Street 1:289 OLMSTED BLVD
Practice Address - Street 2:SUIE 1
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-8729
Practice Address - Country:US
Practice Address - Phone:910-295-6007
Practice Address - Fax:877-256-8588
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-21
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6064101YP2500X
NC10322101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional