MEDICARE: MRS. PAMELA HARRIS-JONES 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	A12374	NC
2	101YM0800X	Mental Health Counselor	12374	NC

General Provider Information

NPI Number	:	1447702469
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PAMELA HARRIS-JONES LPC

Provider Business Mailing Address
First Line	:	3204 SEATTLE CT
Second Line	:	WAKE FOREST
City	:	WAKE FOREST
State	:	NC
Zip	:	27587-9381
Country	:	US
Telephone Number	:	919-217-5590
Fax Number	:

Provider Business Practice Location Address
First Line	:	3204 SEATTLE CT
Second Line	:	WAKE FOREST
City	:	WAKE FOREST
State	:	NC
Zip	:	27587-9381
Country	:	US
Telephone Number	:	919-217-5590
Fax Number	:

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

Provider Enumeration Date	:	10/25/2016
Last Update Date	:	03/21/2019

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