Provider Demographics
NPI:1548761620
Name:ERVIN, ANA-MARIA (LCMHC)
Entity type:Individual
Prefix:
First Name:ANA-MARIA
Middle Name:
Last Name:ERVIN
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 N FRONT ST STE 304
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-3908
Mailing Address - Country:US
Mailing Address - Phone:910-773-1826
Mailing Address - Fax:
Practice Address - Street 1:321 N FRONT ST STE 304
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-3908
Practice Address - Country:US
Practice Address - Phone:910-773-1826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-23
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13297101YM0800X, 101Y00000X
NCA101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional