Provider Demographics
NPI:1508026535
Name:MOORE, PAMELA S (LCSW)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:S
Last Name:MOORE
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:PO BOX 1541
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS
Mailing Address - State:NC
Mailing Address - Zip Code:28741-1541
Mailing Address - Country:US
Mailing Address - Phone:828-226-8080
Mailing Address - Fax:
Practice Address - Street 1:194 WEBBMONT ROAD
Practice Address - Street 2:
Practice Address - City:HIGHLANDS
Practice Address - State:NC
Practice Address - Zip Code:28741
Practice Address - Country:US
Practice Address - Phone:828-226-8080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-12
Last Update Date:2018-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0053161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical