Provider Demographics
NPI:1356094189
Name:MOTLEY, ERIN MOSES (LPC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:MOSES
Last Name:MOTLEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:ONEAL
Other - Last Name:MOSES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:173 CANTERBURY LN
Mailing Address - Street 2:
Mailing Address - City:RIDGEWAY
Mailing Address - State:VA
Mailing Address - Zip Code:24148-3309
Mailing Address - Country:US
Mailing Address - Phone:276-732-6336
Mailing Address - Fax:
Practice Address - Street 1:245 HAIRSTON ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-4137
Practice Address - Country:US
Practice Address - Phone:434-483-2037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-01
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701011166101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0701011166OtherLICENSED NUMBER FOR PROFESSIONAL COUNSELOR