Healthcare Provider Details

I. General information

NPI: 1134645781
Provider Name (Legal Business Name): NANCY RIESMEYER PUGMIRE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2017
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 PALISADE LOOP
PAWLEYS ISLAND SC
29585-7834
US

IV. Provider business mailing address

112 PALISADE LOOP
PAWLEYS ISLAND SC
29585-7834
US

V. Phone/Fax

Practice location:
  • Phone: 404-840-1901
  • Fax:
Mailing address:
  • Phone: 404-840-1901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number009364
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: