Basic Information
| Provider Information | |||||||||
| NPI: | 1558500769 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LINDEMAN | ||||||||
| FirstName: | PAMELA | ||||||||
| MiddleName: | SUE | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | M.ED., LSW. PC | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 555 CINCINNATI BATAVIA PIKE | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452441557 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5136855049 | ||||||||
| FaxNumber: | 5136888155 | ||||||||
| Practice Location | |||||||||
| Address1: | 555 CINCINNATI BATAVIA PIKE | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452441557 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5136855049 | ||||||||
| FaxNumber: | 5136888155 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/11/2009 | ||||||||
| LastUpdateDate: | 02/11/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | C-0016333 | OH | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health | 251S00000X | C-0016333 | OH | N | Agencies | Community/Behavioral Health |
No ID Information.