Provider Demographics
NPI:1952450322
Name:KIRKPATRICK, PAMELA PATTERSON (MSW)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:PATTERSON
Last Name:KIRKPATRICK
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 FEARRINGTON POST
Mailing Address - Street 2:
Mailing Address - City:PITTSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27312-8568
Mailing Address - Country:US
Mailing Address - Phone:919-542-2935
Mailing Address - Fax:
Practice Address - Street 1:530 FEARRINGTON POST
Practice Address - Street 2:530 WEATHERSFIELD
Practice Address - City:PITTSBORO
Practice Address - State:NC
Practice Address - Zip Code:27312-8568
Practice Address - Country:US
Practice Address - Phone:919-542-2935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLICENSE # 90-LCSW101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC60330OtherBLUE CROS BLUE SHIELD