Provider Demographics
NPI:1700250818
Name:ERVIN, ESTHER (LPC)
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:
Last Name:ERVIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 PRICE HILL RD
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26501-2319
Mailing Address - Country:US
Mailing Address - Phone:304-680-5199
Mailing Address - Fax:
Practice Address - Street 1:50 CLAY ST
Practice Address - Street 2:STE. 3
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26501-5932
Practice Address - Country:US
Practice Address - Phone:304-381-4831
Practice Address - Fax:304-381-4826
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-01
Last Update Date:2017-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2203101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health