Provider Demographics
NPI:1275666851
Name:BAUGH, PAMELA C (LCSW)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:C
Last Name:BAUGH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:895 STATE FARM RD
Mailing Address - Street 2:SUITE 508
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-4917
Mailing Address - Country:US
Mailing Address - Phone:828-264-9007
Mailing Address - Fax:828-262-5687
Practice Address - Street 1:1430 WILLOW LN
Practice Address - Street 2:WEST PARK C61-2
Practice Address - City:NORTH WILKESBORO
Practice Address - State:NC
Practice Address - Zip Code:28659-3551
Practice Address - Country:US
Practice Address - Phone:336-667-5151
Practice Address - Fax:828-262-5687
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0059721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical