Provider Demographics
NPI:1053779330
Name:MCRAE, PAMELA SUE (LCSW-C)
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:SUE
Last Name:MCRAE
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2970 BELCREST CENTER DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-1987
Mailing Address - Country:US
Mailing Address - Phone:240-467-2100
Mailing Address - Fax:240-467-2120
Practice Address - Street 1:2970 BELCREST CENTER DR
Practice Address - Street 2:SUITE 300
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782-1987
Practice Address - Country:US
Practice Address - Phone:240-467-2100
Practice Address - Fax:240-467-2120
Is Sole Proprietor?:No
Enumeration Date:2016-02-02
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD072991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical