Individual provider Active NPI

Audrey Van Pamel

  • Addiction (Substance Use Disorder) Counselor
  • Pontiac, MI
National Provider Identifier
1306197397
Registry record updated Oct 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
6803085349 Issued in MI
Practice address
54 Seneca St
Pontiac, MI 48342-2349
Phone
(248) 836-0191
Fax
(248) 836-0199
NPI assigned
Oct 1, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 6803085349 MI Primary

Addresses

Primary practice location

54 Seneca St
Pontiac, MI 48342-2349

Mailing address

31 Clair St
Mount Clemens, MI 48043-1705
Phone (586) 649-8672

Other names 1

  • Audrey Sciandra Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6803085349MIMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1349049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349049600000",
    "number": "1306197397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 CLAIR ST",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480431705",
            "telephone_number": "586-649-8672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 SENECA ST",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483422349",
            "telephone_number": "248-836-0191",
            "fax_number": "248-836-0199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN PAMEL",
        "first_name": "AUDREY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-01",
        "last_updated": "2012-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "6803085349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUDREY",
            "last_name": "SCIANDRA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pontiac, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.