Provider Demographics
NPI:1558817999
Name:BIVINS, PAMELA DANNETTE (LPC-S,LMFT,NCC,JSOCC)
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:DANNETTE
Last Name:BIVINS
Suffix:
Gender:F
Credentials:LPC-S,LMFT,NCC,JSOCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 SOUTHLAKE LN STE 370
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-3327
Mailing Address - Country:US
Mailing Address - Phone:205-201-0060
Mailing Address - Fax:833-853-4391
Practice Address - Street 1:15 SOUTHLAKE LN STE 370
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-3327
Practice Address - Country:US
Practice Address - Phone:205-201-0060
Practice Address - Fax:833-853-4391
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-26
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALL545106H00000X, 106H00000X
AL3780101YP2500X, 101YM0800X, 101YP2500X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health