Healthcare Provider Details

I. General information

NPI: 1710426572
Provider Name (Legal Business Name): ERIN R CANTALINI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERIN R RICE

II. Dates (important events)

Enumeration Date: 02/13/2017
Last Update Date: 09/27/2021
Certification Date: 09/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 WINDING GAP RD
LAKE TOXAWAY NC
28747-8786
US

IV. Provider business mailing address

1498 WARWOMAN RD
CLAYTON GA
30525-5242
US

V. Phone/Fax

Practice location:
  • Phone: 828-457-7815
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6527
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number16531
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: