Provider Demographics
NPI:1770187759
Name:HILL, PAMELA GANT (LCMHCA)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:GANT
Last Name:HILL
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 OAKVILLE CT
Mailing Address - Street 2:
Mailing Address - City:MC LEANSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27301-9526
Mailing Address - Country:US
Mailing Address - Phone:336-587-3583
Mailing Address - Fax:
Practice Address - Street 1:6 OAKVILLE CT
Practice Address - Street 2:
Practice Address - City:MC LEANSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27301-9526
Practice Address - Country:US
Practice Address - Phone:336-587-3583
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1198233101YS0200X
NCA15767101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool