Provider Demographics
NPI:1558817999
Name:BIVINS, PAMELA DANNETTE (LPC,LMFT,NCC,JSOCC)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:DANNETTE
Last Name:BIVINS
Suffix:
Gender:F
Credentials:LPC,LMFT,NCC,JSOCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 PROVIDENCE PARK STE 250
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-4694
Mailing Address - Country:US
Mailing Address - Phone:205-201-0060
Mailing Address - Fax:833-853-4391
Practice Address - Street 1:1401 PROVIDENCE PARK STE 250
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-4694
Practice Address - Country:US
Practice Address - Phone:205-201-0060
Practice Address - Fax:833-853-4391
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-26
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALC2502A101YM0800X
106H00000X, 101YP2500X
ALL545106H00000X
AL3780101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional