Healthcare Provider Details

I. General information

NPI: 1982914636
Provider Name (Legal Business Name): ERINN ELZIE MSW, P-LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/15/2010
Last Update Date: 10/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4824 PARKWAY PLAZA BLVD SUITE 290
CHARLOTTE NC
28217-1970
US

IV. Provider business mailing address

4824 PARKWAY PLAZA BLVD SUITE 290
CHARLOTTE NC
28217-1970
US

V. Phone/Fax

Practice location:
  • Phone: 704-423-0051
  • Fax: 704-329-0190
Mailing address:
  • Phone: 704-423-0051
  • Fax: 704-329-0190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: