Provider Demographics
NPI:1386998334
Name:TREMBLAY, PAMELA SCOTTO (LPC)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:SCOTTO
Last Name:TREMBLAY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:ANN
Other - Last Name:SCOTTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:90 BELLVIEW RDG
Mailing Address - Street 2:
Mailing Address - City:SHARPSBURG
Mailing Address - State:GA
Mailing Address - Zip Code:30277-1556
Mailing Address - Country:US
Mailing Address - Phone:678-778-7313
Mailing Address - Fax:
Practice Address - Street 1:285 W WIEUCA RD NE STE 5441
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-3321
Practice Address - Country:US
Practice Address - Phone:678-559-9510
Practice Address - Fax:770-995-1959
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-30
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC003248101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional