Provider Demographics
NPI:1013441104
Name:POORE, ERIN (LPCA, LCASA)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:POORE
Suffix:
Gender:F
Credentials:LPCA, LCASA
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:
Other - Last Name:KRAMER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPCA, LCASA
Mailing Address - Street 1:117 HAMPSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28115-8501
Mailing Address - Country:US
Mailing Address - Phone:704-658-8558
Mailing Address - Fax:
Practice Address - Street 1:117 HAMPSHIRE DR
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28115-8501
Practice Address - Country:US
Practice Address - Phone:704-658-8558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-14
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-22450101YA0400X
NCA12381101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)