Healthcare Provider Details

I. General information

NPI: 1609885664
Provider Name (Legal Business Name): PAMLICO COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 09/25/2024
Certification Date: 09/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 E 11TH ST
WASHINGTON NC
27889-3719
US

IV. Provider business mailing address

408 E 11TH ST
WASHINGTON NC
27889-3719
US

V. Phone/Fax

Practice location:
  • Phone: 252-975-2027
  • Fax: 252-975-3483
Mailing address:
  • Phone: 252-975-2027
  • Fax: 252-975-3483

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. CATHERINE DEMARTIN MANNING
Title or Position: OWNER
Credential: LCMHC
Phone: 252-975-2027