Provider Demographics
NPI:1548692460
Name:HADDAD, PAMELA KAY (LCSW)
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:KAY
Last Name:HADDAD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 CLOVER LN
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17022-2221
Mailing Address - Country:US
Mailing Address - Phone:717-367-9252
Mailing Address - Fax:717-367-5855
Practice Address - Street 1:237 N PRINCE ST
Practice Address - Street 2:SUITE 301
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-4062
Practice Address - Country:US
Practice Address - Phone:717-314-9011
Practice Address - Fax:717-367-5855
Is Sole Proprietor?:No
Enumeration Date:2013-08-01
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0172001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical