Provider Demographics
NPI:1629204573
Name:GWINN, ERIN (LPC, MA, QMHP)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:
Last Name:GWINN
Suffix:
Gender:F
Credentials:LPC, MA, QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 HUGUENOT RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23235-4311
Mailing Address - Country:US
Mailing Address - Phone:804-687-1474
Mailing Address - Fax:
Practice Address - Street 1:1901 HUGUENOT RD
Practice Address - Street 2:SUITE 201
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-4311
Practice Address - Country:US
Practice Address - Phone:804-257-9392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-05
Last Update Date:2010-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004568101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional