Provider Demographics
NPI:1609885664
Name:PAMLICO COUNSELING PLLC
Entity Type:Organization
Organization Name:PAMLICO COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:DEMARTIN
Authorized Official - Last Name:MANNING
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:252-975-2027
Mailing Address - Street 1:408 E 11TH ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27889-3719
Mailing Address - Country:US
Mailing Address - Phone:252-975-2027
Mailing Address - Fax:252-975-3483
Practice Address - Street 1:408 E 11TH ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NC
Practice Address - Zip Code:27889-3719
Practice Address - Country:US
Practice Address - Phone:252-975-2027
Practice Address - Fax:252-975-3483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-07
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6005246Medicaid
015RFOtherNC BCBS
305567OtherMHN
NC2342843Medicare PIN