Individual provider Active NPI

Pamala Tatoya Love, PHDC, LCSW, TF-CBT

  • Clinical Social Worker
  • Salisbury, NC
National Provider Identifier
1396892055
Registry record updated Jan 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C006040 Issued in NC
Practice address
1201 Forestdale Dr
Salisbury, NC 28144
Phone
(910) 541-9114
Fax
(336) 447-6112
NPI assigned
Jan 4, 2007
Last updated
Jan 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW006295 GA
Clinical Social Worker 1041C0700X C006040 NC Primary
Clinical Social Worker 1041C0700X SW21082 FL

Addresses

Primary practice location

1201 Forestdale Dr
Salisbury, NC 28144

Mailing address

9526 Argyle Forest Blvd
Ste B2, #602
Jacksonville, FL 32222
Phone (910) 248-9359

Other practice location 1

3653 Princeton Ave
College Park, GA 30337
Phone (404) 404-8034

Other identifiers 3

IdentifierTypeStateIssuer
SW21082OtherFLBOARD OF CLINICAL SOCIAL WORK, MARRIAGE & FAMILY THERAPY AND MENTAL HEALTH COUNS
CSW006295OtherGABOARD OF PROFESSIONAL COUNSELORS, SOCIAL WORKERS, AND MARRIAGE & FAMILY THERAPIS
C006040OtherNCNC SOCIAL WORK CERTIFICATION AND LICENSURE BOARD

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
SW21082FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Clinical Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: pamalalove@tdh.allscriptsdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1396892055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9526 ARGYLE FOREST BLVD",
            "address_2": "STE B2, #602",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32222",
            "telephone_number": "910-248-9359",
            "fax_number": "980-338-8519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 FORESTDALE DR",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "28144",
            "telephone_number": "910-541-9114",
            "fax_number": "336-447-6112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3653 Princeton Ave",
            "address_purpose": "LOCATION",
            "city": "College Park",
            "state": "GA",
            "postal_code": "30337",
            "country_code": "US",
            "telephone_number": "404-404-8034",
            "fax_number": "980-338-8519",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOVE",
        "first_name": "PAMALA",
        "middle_name": "TATOYA",
        "name_prefix": "Ms.",
        "credential": "PHDC, LCSW, TF-CBT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW006295",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C006040",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW21082",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF CLINICAL SOCIAL WORK, MARRIAGE & FAMILY THERAPY AND MENTAL HEALTH COUNS",
            "identifier": "SW21082",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PROFESSIONAL COUNSELORS, SOCIAL WORKERS, AND MARRIAGE & FAMILY THERAPIS",
            "identifier": "CSW006295",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC SOCIAL WORK CERTIFICATION AND LICENSURE BOARD",
            "identifier": "C006040",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; 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.