Provider Demographics
NPI:1467812982
Name:ESMAY, IAN PATRICK (LCMHC)
Entity Type:Individual
Prefix:
First Name:IAN
Middle Name:PATRICK
Last Name:ESMAY
Suffix:
Gender:M
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5906 TATTERSALL DR APT 12
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-9065
Mailing Address - Country:US
Mailing Address - Phone:703-944-8140
Mailing Address - Fax:
Practice Address - Street 1:5906 TATTERSALL DR APT 12
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-9065
Practice Address - Country:US
Practice Address - Phone:703-944-8140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-25
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701006403101YM0800X
NC14111101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty