Healthcare Provider Details

I. General information

NPI: 1548761620
Provider Name (Legal Business Name): ANA-MARIA ERVIN LCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2018
Last Update Date: 03/06/2026
Certification Date: 03/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1213 CULBRETH DR STE 208
WILMINGTON NC
28405-3639
US

IV. Provider business mailing address

1213 CULBRETH DR STE 208
WILMINGTON NC
28405-3639
US

V. Phone/Fax

Practice location:
  • Phone: 910-773-1826
  • Fax: 910-900-7730
Mailing address:
  • Phone: 910-773-1826
  • Fax: 910-900-7730

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number13297
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number13297
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number13297
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: