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Individual

MARINA L ERVIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, LPC, NCC, BCPCC

Contact information

Practice address
502N EAST CORNWALLIS DR, STE B, GREENSBORO, NC 27405-5677
(336) 681-1086
(336) 370-0257
Mailing address
502N EAST CORNWALLIS DR, STE B, GREENSBORO, NC 27405-5677
(336) 681-1086
(336) 370-0257

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3425 LPC
NC
101YP2500X
Professional Counselor
47974 NCC
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
131AP
BCBS/NC HEALTH CHOICE
NC
05
6102031
NC
Enumeration date
05/30/2005
Last updated
10/30/2007
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