Individual provider Active NPI

Pamela Kathleen Carr, APC

  • Counselor
  • Lithonia, GA
National Provider Identifier
1336818996
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
LPC014036 Issued in GA
Practice address
6507 Charter Way
Lithonia, GA 30058-3968
Phone
(678) 851-2366
NPI assigned
Sep 8, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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 1310 GA
Counselor 101Y00000X LPC014036 GA Primary

Addresses

Primary practice location

6507 Charter Way
Lithonia, GA 30058-3968

Mailing address

PO Box 1172
Lithonia, GA 30058-1043
Phone (678) 851-2366

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL pamelacarr77@yahoo.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260622000470 GA Practitioner - Mental Health Counselor 2961975008 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

80 Jesse Hill Jr Dr SE
Box 26019
Atlanta, GA 30303-3031

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC014036GAMDCounselor
1310GAMDClinical Psychologist

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": "1631059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1336818996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1172",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300581043",
            "telephone_number": "678-851-2366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6507 CHARTER WAY",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300583968",
            "telephone_number": "678-851-2366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARR",
        "first_name": "PAMELA",
        "middle_name": "KATHLEEN",
        "name_prefix": "Ms.",
        "credential": "APC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-08",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "GA",
            "license": "1310",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "GA",
            "license": "LPC014036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "pamelacarr77@yahoo.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6507 Charter Way",
            "city": "Lithonia",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300583968",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lithonia, GA

Sources for this page

Verify at the official NPI Registry.