Provider Demographics
NPI:1225230824
Name:PINNICK, ROY GENE (M ED, LPC)
Entity Type:Individual
Prefix:
First Name:ROY
Middle Name:GENE
Last Name:PINNICK
Suffix:
Gender:M
Credentials:M ED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 GRAND CHAMPION RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-2615
Mailing Address - Country:US
Mailing Address - Phone:910-792-8233
Mailing Address - Fax:910-793-8233
Practice Address - Street 1:123 GRAND CHAMPION RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412-2615
Practice Address - Country:US
Practice Address - Phone:910-793-8233
Practice Address - Fax:910-793-8233
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4527101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional