Provider Demographics
NPI:1487002143
Name:KINGSTON, ERIN FLINN (LCWSA)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:FLINN
Last Name:KINGSTON
Suffix:
Gender:F
Credentials:LCWSA
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:MARIE
Other - Last Name:FLINN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSWA
Mailing Address - Street 1:9332 TIBBLE CREEK WAY
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28227-6674
Mailing Address - Country:US
Mailing Address - Phone:704-737-0214
Mailing Address - Fax:
Practice Address - Street 1:2101 SARDIS RD N
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28227-7711
Practice Address - Country:US
Practice Address - Phone:704-737-0214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-02
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0169331041C0700X
SC11588101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)