| Pamela M. Nilsson, Ph.d., Llc | |
|
23811 Chagrin Blvd Ste 248 Beachwood OH 44122-5560 | |
| (216) 789-3878 | |
| (216) 920-6288 |
| Full Name | Pamela M. Nilsson, Ph.d., Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 23811 Chagrin Blvd Ste 248, Beachwood, Ohio |
| Authorized Official Name and Position | Pamela M. Nilsson (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 2167893878 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pamela M. Nilsson, Ph.d., Llc 23811 Chagrin Blvd Ste 248 Beachwood OH 44122-5560 Ph: (216) 299-6843 | Pamela M. Nilsson, Ph.d., Llc 23811 Chagrin Blvd Ste 248 Beachwood OH 44122-5560 Ph: (216) 789-3878 |
| NPI Number | 1447557954 |
|---|---|
| Provider Enumeration Date | 02/17/2011 |
| Last Update Date | 01/20/2022 |
| Certification Date | 01/20/2022 |
| Medicare PECOS PAC ID | 6608260344 |
|---|---|
| Medicare Enrollment ID | O20220223002215 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447557954 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 6455 (Ohio) | Primary |
| Provider Name | Pamela Nilsson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396058327 PECOS PAC ID: 4183844327 Enrollment ID: I20141009002245 |
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