Individual provider Active NPI

Loredana Pampinella, PHD(C), LPC, LCAS-A

  • Mental Health Counselor
  • Charlotte, NC
National Provider Identifier
1134553639
Registry record updated Sep 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
8952 Issued in NC
Practice address
5700 Executive Center Dr Ste 100
Charlotte, NC 28212-8833
Phone
(704) 408-8489
Fax
(855) 532-2779
NPI assigned
Sep 3, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 8952 NC
Mental Health Counselor 101YM0800X 8952 NC Primary

Addresses

Primary practice location

5700 Executive Center Dr Ste 100
Charlotte, NC 28212-8833

Mailing address

5700 Executive Center Drive
Suite 100
Charlotte, NC 28212-8820
Phone (704) 408-8489

Other identifiers 1

IdentifierTypeStateIssuer
00536787MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8952NCMDPhysical Therapist
5642SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
P&G Clinical Services PLLC CurrentSince May 12, 2012 Accepting new patients

Locations

8201 Arrowridge Blvd
Ste 148
Charlotte, NC 28273
Phone (704) 207-0995

5700 Executive Center Dr
Ste 100
Charlotte, NC 28212
Phone (704) 408-8489

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1378166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506384000000",
    "number": "1134553639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 EXECUTIVE CENTER DRIVE",
            "address_2": "SUITE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282128820",
            "telephone_number": "704-408-8489",
            "fax_number": "855-532-2779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 EXECUTIVE CENTER DR STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282128833",
            "telephone_number": "704-408-8489",
            "fax_number": "855-532-2779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAMPINELLA",
        "first_name": "LOREDANA",
        "credential": "PHD(C), LPC, LCAS-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-03",
        "last_updated": "2017-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "8952",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "8952",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00536787",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.