Provider Demographics
NPI:1316096779
Name:DYER, PAMELA RENEE (LPC)
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:RENEE
Last Name:DYER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:PAMELA
Other - Middle Name:RENEE
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2187
Mailing Address - Street 2:
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-2187
Mailing Address - Country:US
Mailing Address - Phone:828-631-3973
Mailing Address - Fax:828-631-9280
Practice Address - Street 1:674 HIGHLANDS RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-9566
Practice Address - Country:US
Practice Address - Phone:828-631-3973
Practice Address - Fax:828-631-9280
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4696101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1409MOtherBCBS PROVIDER #
NC6102288Medicaid