Basic Information
| Provider Information | |||||||||
| NPI: | 1811025729 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DOANE | ||||||||
| FirstName: | PAMELA | ||||||||
| MiddleName: | IREAN | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | LMHC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 30 N SHETLAND RD | ||||||||
| Address2: | |||||||||
| City: | DANVERS | ||||||||
| State: | MA | ||||||||
| PostalCode: | 019232422 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9787506828 | ||||||||
| FaxNumber: | 9787506684 | ||||||||
| Practice Location | |||||||||
| Address1: | 65 NEWBURY ST | ||||||||
| Address2: | |||||||||
| City: | DANVERS | ||||||||
| State: | MA | ||||||||
| PostalCode: | 019231040 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9787596828 | ||||||||
| FaxNumber: | 9787506684 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/01/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 5944 | MA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.