Individual provider Active NPI

Pamela Hines, MSW, LCSW

  • Clinical Social Worker
  • Durham, NC
National Provider Identifier
1477101582
Registry record updated Oct 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C008259 Issued in NC
Practice address
2003 Chapel Hill Rd
Durham, NC 27707-1109
Phone
(919) 807-1836
NPI assigned
Sep 1, 2019
Last updated
Oct 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C008259 NC Primary

Addresses

Primary practice location

2003 Chapel Hill Rd
Durham, NC 27707-1109

Mailing address

711 N Main St Ste B
Roxboro, NC 27573-4765
Phone (919) 807-1836

Other practice location 1

711 N Main St Ste B
Roxboro, NC 27573-4765
Phone (919) 807-1836

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210908004161 VA Practitioner - Clinical Social Worker 6406252907 Reassigns benefits to 1 organization
I20221116001287 NC Practitioner - Clinical Social Worker 6406252907 Practice locations: Roxboro, NC; Durham, NC

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Southside Behavioral Health Clinical CurrentSince Aug 1, 2021 Accepting new patients

Locations

424 Hamilton Blvd
South Boston, VA 24592
Phone (434) 572-2936

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": "1567296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1477101582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 N MAIN ST STE B",
            "city": "ROXBORO",
            "state": "NC",
            "postal_code": "275734765",
            "telephone_number": "919-807-1836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 CHAPEL HILL RD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277071109",
            "telephone_number": "919-807-1836"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "711 N Main St Ste B",
            "address_purpose": "LOCATION",
            "city": "Roxboro",
            "state": "NC",
            "postal_code": "275734765",
            "country_code": "US",
            "telephone_number": "919-807-1836",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HINES",
        "first_name": "PAMELA",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-01",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C008259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.