Provider Demographics
NPI:1215422258
Name:POKORNEY, TRAM (LPCA)
Entity type:Individual
Prefix:
First Name:TRAM
Middle Name:
Last Name:POKORNEY
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18809 W CATAWBA AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-5548
Mailing Address - Country:US
Mailing Address - Phone:704-840-5035
Mailing Address - Fax:
Practice Address - Street 1:18809 W CATAWBA AVE STE 202
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-5548
Practice Address - Country:US
Practice Address - Phone:704-840-5035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-22
Last Update Date:2018-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA13752101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health