Healthcare Provider Details

I. General information

NPI: 1629932496
Provider Name (Legal Business Name): ELIZABETH AHERN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 ANSON CIR
GREENSBORO NC
27407-7260
US

IV. Provider business mailing address

3 ANSON CIR
GREENSBORO NC
27407-7260
US

V. Phone/Fax

Practice location:
  • Phone: 850-938-3327
  • Fax:
Mailing address:
  • Phone: 850-938-3327
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberA18739
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: