Provider Demographics
NPI:1467069484
Name:BOYLE, ERIN ELIZABETH (LCMHCA)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:ELIZABETH
Last Name:BOYLE
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 MACK RD STE B
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27205-1066
Mailing Address - Country:US
Mailing Address - Phone:518-339-3966
Mailing Address - Fax:
Practice Address - Street 1:300 MACK RD STE B
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27205-1066
Practice Address - Country:US
Practice Address - Phone:518-339-3966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-24
Last Update Date:2021-11-11
Deactivation Date:2021-10-07
Deactivation Code:
Reactivation Date:2021-11-11
Provider Licenses
StateLicense IDTaxonomies
NYP08779101Y00000X
NCA17006101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor