Provider Demographics
NPI:1851997662
Name:BYRNE, ERIN (LCMHC-A, NCC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:BYRNE
Suffix:
Gender:F
Credentials:LCMHC-A, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3024 VENTOSA DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-3241
Mailing Address - Country:US
Mailing Address - Phone:281-814-4179
Mailing Address - Fax:
Practice Address - Street 1:3024 VENTOSA DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28205-3241
Practice Address - Country:US
Practice Address - Phone:281-814-4179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-07
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA15240101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty