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General NPI Number Information
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NPI Number | 1871839845
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Entity Type | Individual
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Provider Name | PAMELA MICHELLE MOORE-HARDISON MA, MSW
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Gender | Female
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Dates
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Enumeration Date | 12/19/2012
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Last Update Date | 01/13/2020
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Provider Practice Location Address
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Address Line | 1198 GREY FARM RD
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City | JAMESVILLE
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State | NC
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Zip | 27846
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Country | US
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Telephone | 252-741-9119
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Fax | 252-741-9119
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Provider Business Mailing Address
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Address Line | 1198 GREY FARM RD
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City | JAMESVILLE
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State | NC
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Zip | 27846-9630
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Country | US
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Telephone | 252-799-1916
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Fax | 252-741-9119
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 3185
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 9919
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C010046
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License Number State | NC
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