Provider Demographics
NPI:1861979205
Name:MAYHUGH, PAMELA (LMSW, AADC, MCM)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:MAYHUGH
Suffix:
Gender:F
Credentials:LMSW, AADC, MCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 PROFESSIONAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:SC
Mailing Address - Zip Code:29526-9260
Mailing Address - Country:US
Mailing Address - Phone:843-234-8250
Mailing Address - Fax:843-234-8234
Practice Address - Street 1:100 PROFESSIONAL PARK DR
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:SC
Practice Address - Zip Code:29526-9260
Practice Address - Country:US
Practice Address - Phone:843-234-8250
Practice Address - Fax:843-234-8234
Is Sole Proprietor?:No
Enumeration Date:2018-07-27
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1705161101YA0400X
SC17513104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)