Provider Demographics
NPI:1497352413
Name:CALLAN, ERIN LANGLEY (LCMHC)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:LANGLEY
Last Name:CALLAN
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:490 RAVEN RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:KERNERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27284-8046
Mailing Address - Country:US
Mailing Address - Phone:336-918-2096
Mailing Address - Fax:
Practice Address - Street 1:490 RAVEN RIDGE RD
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-8046
Practice Address - Country:US
Practice Address - Phone:336-918-2096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-02
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA16020101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health