Provider Demographics
NPI:1609829779
Name:RAYMOND, PAMELA M (RN, LPC)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:M
Last Name:RAYMOND
Suffix:
Gender:F
Credentials:RN, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 LOVERS LOOP RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-9550
Mailing Address - Country:US
Mailing Address - Phone:828-298-2555
Mailing Address - Fax:
Practice Address - Street 1:166 E CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-2337
Practice Address - Country:US
Practice Address - Phone:828-298-2555
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3709101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6103006Medicaid