Provider Demographics
NPI:1821030370
Name:EPPERSON, PAMELA LEWIS (LP)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:LEWIS
Last Name:EPPERSON
Suffix:
Gender:F
Credentials:LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4611 POWDER MILL RD
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-9546
Mailing Address - Country:US
Mailing Address - Phone:919-383-4146
Mailing Address - Fax:
Practice Address - Street 1:209 MILLSTONE DR STE A
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NC
Practice Address - Zip Code:27278-8776
Practice Address - Country:US
Practice Address - Phone:919-245-5400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-11
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1070101YM0800X
NCNC1070103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2819235Medicaid