Grassbaugh, Pamela Jane
Grassbaugh, Pamela Jane is an individual health care provider with primary practice located at 1720 E. 32Nd St. , Silver City NM 88061. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Grassbaugh, Pamela Jane can be contacted via phone (505) 388-2693.Contact Information
Primary practice address
1720 E. 32Nd St.
Silver City NM 88061
Phone: (505) 388-2693
Fax: (575) 534-0120
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 0145801 | New Mexico |
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 0117671 | New Mexico |
| Behavioral Health & Social Service Providers / Professional | 101YP2500X |
Profile Details
| NPI number | 1366539819 |
|---|---|
| LBN Legal business name | Grassbaugh, Pamela Jane |
| Credentials | LPCC., LADAC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 6th, 2006 |
| Last updated | Apr 2nd, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366539819 | NPPES |
| New Mexico | MEDICAID | 18677037 | |
| New Mexico | MEDICAID | 54788854 |
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