Provider Demographics
NPI:1194171900
Name:SPECHT, PAMELA (LPCI)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:SPECHT
Suffix:
Gender:F
Credentials:LPCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2620 SIX AND TWENTY RD
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:SC
Mailing Address - Zip Code:29670-9746
Mailing Address - Country:US
Mailing Address - Phone:864-617-4177
Mailing Address - Fax:
Practice Address - Street 1:515 CAMSON RD
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29625-1407
Practice Address - Country:US
Practice Address - Phone:864-716-2316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-11
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6343101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional