Provider Demographics
NPI:1922354851
Name:VASQUEZ, ERIN MARIE (LCSW-A)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:MARIE
Last Name:VASQUEZ
Suffix:
Gender:F
Credentials:LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 S STEELE ST
Mailing Address - Street 2:SUITE P
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-4201
Mailing Address - Country:US
Mailing Address - Phone:919-776-0303
Mailing Address - Fax:
Practice Address - Street 1:138 S STEELE ST
Practice Address - Street 2:SUITE P
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-4201
Practice Address - Country:US
Practice Address - Phone:919-776-0303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-30
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP007558101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health