Individual
ERIN GRACE VAN VACTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NCC, LCMHC, M.S.
Contact information
Practice address
205 S BOLING STREET, CLAYTON, NC 27520
(919) 297-8656
Mailing address
205 S BOLING STREET, CLAYTON, NC 27527
(199) 297-8656
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
14024
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1386137768
NPI
NC
Enumeration date
06/11/2018
Last updated
04/18/2024
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