Basic Information
| Provider Information | |||||||||
| NPI: | 1336320993 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PERKINS | ||||||||
| FirstName: | PAMELA | ||||||||
| MiddleName: | S. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PSY.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | STRENING | ||||||||
| OtherFirstName: | PAMELA | ||||||||
| OtherMiddleName: | VERNACE | ||||||||
| OtherNamePrefix: | MS. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | M.A. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 10580 LIGON MILL RD | ||||||||
| Address2: | STE 210 | ||||||||
| City: | WAKE FOREST | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275876090 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6304410094 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3401 VENTURA CIR | ||||||||
| Address2: | |||||||||
| City: | WAKE FOREST | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275879390 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6304410094 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/23/2007 | ||||||||
| LastUpdateDate: | 12/21/2016 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 102918 | NC | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical | 103TH0100X | 102918 | NC | N | Behavioral Health & Social Service Providers | Psychologist | Health Service | 103TA0700X | 102918 | NC | N | Behavioral Health & Social Service Providers | Psychologist | Adult Development & Aging |
No ID Information.