Provider Demographics
NPI:1205283611
Name:BULL, PAMELA MARIE (MA, LPCC)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:MARIE
Last Name:BULL
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:MARIE
Other - Last Name:ZAFFKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LPCC
Mailing Address - Street 1:1403 SILVER LAKE RD NW STE 2
Mailing Address - Street 2:
Mailing Address - City:NEW BRIGHTON
Mailing Address - State:MN
Mailing Address - Zip Code:55112-9308
Mailing Address - Country:US
Mailing Address - Phone:612-756-9227
Mailing Address - Fax:
Practice Address - Street 1:1403 SILVER LAKE RD NW STE 2
Practice Address - Street 2:
Practice Address - City:NEW BRIGHTON
Practice Address - State:MN
Practice Address - Zip Code:55112-9308
Practice Address - Country:US
Practice Address - Phone:612-756-9227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-17
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN02636101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional