Provider Demographics
NPI:1134553639
Name:PAMPINELLA, LOREDANA (PHD(C), LPC, LCAS-A)
Entity type:Individual
Prefix:
First Name:LOREDANA
Middle Name:
Last Name:PAMPINELLA
Suffix:
Gender:F
Credentials:PHD(C), LPC, LCAS-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5700 EXECUTIVE CENTER DRIVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28212-8820
Mailing Address - Country:US
Mailing Address - Phone:704-408-8489
Mailing Address - Fax:855-532-2779
Practice Address - Street 1:5700 EXECUTIVE CENTER DR STE 100
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28212-8833
Practice Address - Country:US
Practice Address - Phone:704-408-8489
Practice Address - Fax:855-532-2779
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-03
Last Update Date:2017-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8952101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC00536787Medicaid