Pamella B Divinity

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

6656 Issued in LA

Practice address

2150 General Pershing St
Mandeville, LA 70448-5125

Phone

(985) 465-4250

NPI assigned

Oct 4, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mrs. Pamella B Divinity Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1475539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544400000000",
    "number": "1356891246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1385",
            "address_2": "12434 HOLLINS ROAD",
            "city": "FOLSOM",
            "state": "LA",
            "postal_code": "704371385",
            "telephone_number": "985-237-4930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 GENERAL PERSHING ST",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704485125",
            "telephone_number": "985-465-4250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIVINITY",
        "first_name": "PAMELLA",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-04",
        "last_updated": "2018-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "LA",
            "license": "6656",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "LA",
            "license": "6656",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAMELLA",
            "last_name": "DIVINITY",
            "middle_name": "B",
            "prefix": "MRS.",
            "credential": "M.ED., PLPC, NCC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Case Manager/Care Coordinator in Mandeville, LA
• Providers in Mandeville, LA by specialty
• Case Manager/Care Coordinator in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2018; 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.