Provider Demographics
NPI:1518917475
Name:PASCARELLA, AMY M (MS, LPC, LLC)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:M
Last Name:PASCARELLA
Suffix:
Gender:F
Credentials:MS, LPC, LLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:719 S LAKE DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-3432
Mailing Address - Country:US
Mailing Address - Phone:803-756-3020
Mailing Address - Fax:803-756-3022
Practice Address - Street 1:719 S LAKE DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-3432
Practice Address - Country:US
Practice Address - Phone:803-756-3020
Practice Address - Fax:803-756-3022
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
SC5076101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health