Provider Demographics
NPI:1134269376
Name:PEARCE, PAMELA (MS, NCC, LPC MHSP)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:PEARCE
Suffix:
Gender:F
Credentials:MS, NCC, LPC MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:565 STATE ROUTE 186 S
Mailing Address - Street 2:
Mailing Address - City:HUMBOLDT
Mailing Address - State:TN
Mailing Address - Zip Code:38343-6672
Mailing Address - Country:US
Mailing Address - Phone:731-783-0545
Mailing Address - Fax:
Practice Address - Street 1:24 WEATHERFORD SQ
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-2202
Practice Address - Country:US
Practice Address - Phone:731-660-6782
Practice Address - Fax:731-661-9152
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC0000001908101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional