Basic Information
| Provider Information | |||||||||
| NPI: | 1811064108 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GEFELL | ||||||||
| FirstName: | PAMELA | ||||||||
| MiddleName: | SUSAN | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | M.A.,L.M.H.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4180 RIDGE RD | ||||||||
| Address2: | |||||||||
| City: | ELBA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 140589726 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5857579964 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 5130 E MAIN STREET RD | ||||||||
| Address2: | SUITE #2 | ||||||||
| City: | BATAVIA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 140203433 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5853441421 | ||||||||
| FaxNumber: | 5853443047 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/29/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 001266 | NY | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.