MEDICARE: PAMELA SCOTTO TREMBLAY LPC

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	101YP2500X	Professional Counselor	LPC003248	GA

General Provider Information

NPI Number	:	1386998334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAMELA SCOTTO TREMBLAY LPC

Provider Business Mailing Address
First Line	:	90 BELLVIEW RDG
Second Line	:
City	:	SHARPSBURG
State	:	GA
Zip	:	30277-1556
Country	:	US
Telephone Number	:	678-778-7313
Fax Number	:

Provider Business Practice Location Address
First Line	:	285 W WIEUCA RD NE STE 5441
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30342-3321
Country	:	US
Telephone Number	:	678-559-9510
Fax Number	:	770-995-1959

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/30/2012
Last Update Date	:	05/21/2021

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