MEDICARE: PAMPERED PATHS COUNSELING AND CONSULTING PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1184330383
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAMPERED PATHS COUNSELING AND CONSULTING PLLC

Provider Business Mailing Address
First Line	:	2920 FORESTVILLE ROAD
Second Line	:	SUITE 100, PO BOX 3072
City	:	RALEIGH
State	:	NC
Zip	:	27616
Country	:	US
Telephone Number	:	919-438-3445
Fax Number	:

Provider Business Practice Location Address
First Line	:	3204 SEATTLE CT
Second Line	:
City	:	WAKE FOREST
State	:	NC
Zip	:	27587-9381
Country	:	US
Telephone Number	:	919-438-3445
Fax Number	:

Authorized Official
Title or Position	:	COUNSELOR
Name	:	MS. PAMELA HARRIS-JONES
Credential	:	LCMHC
Telephone Number	:	919-413-2065

Provider Enumeration Date	:	01/31/2023
Last Update Date	:	01/31/2023

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