MEDICARE: LINDA R POMEROY

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	:	1720666340
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA R POMEROY

Provider Business Mailing Address
First Line	:	895 PINNER PL
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29577-4271
Country	:	US
Telephone Number	:	715-299-4669
Fax Number	:

Provider Business Practice Location Address
First Line	:	895 PINNER PL
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29577-4271
Country	:	US
Telephone Number	:	715-299-4669
Fax Number	:

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

Provider Enumeration Date	:	04/02/2021
Last Update Date	:	04/02/2021

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Directions to “ LINDA R POMEROY ” Practice Location

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