Provider Demographics
NPI:1174827737
Name:FLOYD, PAMELA TAYLOR (LCSW)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:TAYLOR
Last Name:FLOYD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:567 E HARGETT ST
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27601-1517
Mailing Address - Country:US
Mailing Address - Phone:919-856-5247
Mailing Address - Fax:919-664-7721
Practice Address - Street 1:567 E HARGETT ST
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27601-1517
Practice Address - Country:US
Practice Address - Phone:919-856-5247
Practice Address - Fax:919-664-7721
Is Sole Proprietor?:No
Enumeration Date:2010-12-22
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0070971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical