Provider Demographics
NPI:1851447882
Name:RICHEY, PAMELA FORDHAM (RN, LMFT)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:FORDHAM
Last Name:RICHEY
Suffix:
Gender:F
Credentials:RN, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 LURE CT
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-7901
Mailing Address - Country:US
Mailing Address - Phone:919-484-2623
Mailing Address - Fax:
Practice Address - Street 1:1502 HIGHWAY 54 WEST,
Practice Address - Street 2:SUITE 505
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707
Practice Address - Country:US
Practice Address - Phone:919-641-8525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC548106H00000X
NC54244163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC131AMOtherBLUE CROSS BLUE SHIELD