Basic Information
| Provider Information | |||||||||
| NPI: | 1679850531 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ERVIN | ||||||||
| FirstName: | CAMEY | ||||||||
| MiddleName: | H | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | M.ED, LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3132 | ||||||||
| Address2: | |||||||||
| City: | MORGANTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286803132 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8283345710 | ||||||||
| FaxNumber: | 8284334576 | ||||||||
| Practice Location | |||||||||
| Address1: | 216 EDGEWOOD CIR | ||||||||
| Address2: | |||||||||
| City: | MORGANTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286558021 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8283345710 | ||||||||
| FaxNumber: | 8284334576 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/07/2011 | ||||||||
| LastUpdateDate: | 11/07/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | NC | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.