Provider Demographics
NPI:1295376812
Name:COLLINS, PAMELA ANN (LPCA)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:ANN
Last Name:COLLINS
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:174 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:WHISPERING PINES
Mailing Address - State:NC
Mailing Address - Zip Code:28327-9408
Mailing Address - Country:US
Mailing Address - Phone:910-603-7121
Mailing Address - Fax:
Practice Address - Street 1:305 PAGE RD N STE 6
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-4619
Practice Address - Country:US
Practice Address - Phone:910-603-7121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-04
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA13450101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health