Provider Demographics
NPI:1922380674
Name:BLAND, ERIN KAY (LSCW)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:KAY
Last Name:BLAND
Suffix:
Gender:F
Credentials:LSCW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 JONES FRANKLIN RD STE 104
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-3379
Mailing Address - Country:US
Mailing Address - Phone:919-851-3555
Mailing Address - Fax:
Practice Address - Street 1:1215 JONES FRANKLIN RD STE 201
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-3351
Practice Address - Country:US
Practice Address - Phone:919-851-3555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-19
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC007279101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional