Provider Demographics
NPI:1114073004
Name:MAYHEW, ERIC DOUGLAS (MS, LPC)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:DOUGLAS
Last Name:MAYHEW
Suffix:
Gender:M
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 RUBY ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-4139
Mailing Address - Country:US
Mailing Address - Phone:919-606-8098
Mailing Address - Fax:
Practice Address - Street 1:2304 S MIAMI BLVD
Practice Address - Street 2:SUITE 221
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-4916
Practice Address - Country:US
Practice Address - Phone:919-806-0509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NC7716101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health