Provider Demographics
NPI:1548614696
Name:DANCE, PAMELA GAYE (LISW-CP)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:GAYE
Last Name:DANCE
Suffix:
Gender:F
Credentials:LISW-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 UPWARD WAY
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29642-1659
Mailing Address - Country:US
Mailing Address - Phone:406-431-2600
Mailing Address - Fax:
Practice Address - Street 1:105 UPWARD WAY
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29642-1659
Practice Address - Country:US
Practice Address - Phone:406-431-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-14
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC163891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical