Provider Demographics
NPI:1558587055
Name:PAMELA J MEEDS PSY D PA
Entity Type:Organization
Organization Name:PAMELA J MEEDS PSY D PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:MEEDS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:704-662-0124
Mailing Address - Street 1:116 S MAIN ST
Mailing Address - Street 2:SUITE 207
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28115-2372
Mailing Address - Country:US
Mailing Address - Phone:704-662-0124
Mailing Address - Fax:704-662-9192
Practice Address - Street 1:116 S MAIN ST
Practice Address - Street 2:SUITE 207
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28115-2372
Practice Address - Country:US
Practice Address - Phone:704-662-0124
Practice Address - Fax:704-662-9192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0220103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty