Pamela Elder Pinckney
Individual provider Active NPI Professional Counselor · Tyrone, GA
NPI 1194244731 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1194244731
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- LPC009503 (GA)
- Practice address
- 179 Handley Rd Ste D8
Tyrone, GA 30290-2152 - Phone
- (404) 819-2945
- NPI assigned
- Sep 14, 2017
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC009503 | GA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Manifested Destiny Counseling | Professional | Current |
Accepting new patients |
| Access Counseling, LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC009503 | GA | Yes |
Addresses
Primary practice location
179 Handley Rd Ste D8
Tyrone, GA 30290-2152
Mailing address
120 Longmeadow CT
Fayetteville, GA 30214-5373
Phone (678) 682-0415
Other practice location 1
277 Highway 74 N Ste 306
Peachtree City, GA 30269-1571
Phone (678) 383-1210
Other providers in Tyrone, GA
- Karen Y Paz
- Gabriel Perez-Gonzalez
- Diem Thuy Quynh Phan
- Stacey Phillips
- Phyzer Homehealth Services,Inc
- Samanatha Pinkston
- Marat V Plotkin
- PMC Long Term Care, LLC
- Amy Poole
- Cally B Pospisil
All providers in Tyrone, GA · Professional Counselor in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.