Provider Demographics
NPI:1396949301
Name:PIERCE, PAMELA LYNN (MA, NCC, LCADC)
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:LYNN
Last Name:PIERCE
Suffix:
Gender:F
Credentials:MA, NCC, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 980
Mailing Address - Street 2:
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678-0980
Mailing Address - Country:US
Mailing Address - Phone:410-535-5400
Mailing Address - Fax:410-535-2220
Practice Address - Street 1:280 STAFFORD RD
Practice Address - Street 2:
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-3582
Practice Address - Country:US
Practice Address - Phone:410-535-3079
Practice Address - Fax:410-535-2220
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCA210101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)