Ervin, Marina L
Ervin, Marina L is an sole proprietor health care provider with primary practice located at 502N East Cornwallis Dr Ste B, Greensboro NC 27405-5677. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Ervin, Marina L can be contacted via phone (336) 681-1086.Contact Information
Primary practice address
502N East Cornwallis Dr Ste B
Greensboro NC 27405-5677
Phone: (336) 681-1086
Fax: (336) 370-0257
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Professional | 101YP2500X | 47974 NCC | North Carolina |
Behavioral Health & Social Service Providers / Professional | 101YP2500X | 3425 LPC | North Carolina |
Profile Details
NPI number | 1790788206 |
---|---|
LBN Legal business name | Ervin, Marina L |
Credentials | MS, LPC, NCC, BCPCC |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | May 30th, 2005 |
Last updated | Oct 30th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1790788206 | NPPES |
North Carolina | MEDICAID | 6102031 | |
North Carolina | Other | 131AP |
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