Provider Demographics
NPI:1821489188
Name:ULTRA VIOLET MENTAL HEALTH
Entity Type:Organization
Organization Name:ULTRA VIOLET MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ERRANTE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:704-870-8108
Mailing Address - Street 1:1930 JAKE ALEXANDER BLVD W STE 1020
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28147-1185
Mailing Address - Country:US
Mailing Address - Phone:704-870-8108
Mailing Address - Fax:704-870-8110
Practice Address - Street 1:1930 JAKE ALEXANDER BLVD W STE 1020
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28147-1185
Practice Address - Country:US
Practice Address - Phone:704-870-8108
Practice Address - Fax:704-870-8110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-09
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X, 363LP0808X, 261QM1300X
NC1041C0700X
NC950013363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty