Provider Demographics
NPI:1932643426
Name:ELLIOTT, ERICA (MA, NCC, LCMHC)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:MA, NCC, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 N 35TH ST STE 1
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-3186
Mailing Address - Country:US
Mailing Address - Phone:252-205-0545
Mailing Address - Fax:
Practice Address - Street 1:215 N 35TH ST STE 1
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-3186
Practice Address - Country:US
Practice Address - Phone:252-205-0545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-19
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA12674101YM0800X
NC12674101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health