Provider Demographics
NPI:1548727860
Name:FRANCKEN, PAMELA SUSAN
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:SUSAN
Last Name:FRANCKEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 EMMET ST
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-2910
Mailing Address - Country:US
Mailing Address - Phone:231-347-9313
Mailing Address - Fax:
Practice Address - Street 1:520 N MAIN ST STE 202
Practice Address - Street 2:
Practice Address - City:CHEBOYGAN
Practice Address - State:MI
Practice Address - Zip Code:49721-1162
Practice Address - Country:US
Practice Address - Phone:231-597-9235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-22
Last Update Date:2019-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6401011860OtherLIMITED LICENSE PROFESSIONAL COUNSELOR