Healthcare Provider Details

I. General information

NPI: 1346050432
Provider Name (Legal Business Name): ERIN MARIE HOUGH CSAC-S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2025
Last Update Date: 01/10/2025
Certification Date: 01/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1258 HOLLAND RD
SUFFOLK VA
23434-6313
US

IV. Provider business mailing address

3806 TOWNE POINT RD APT E
PORTSMOUTH VA
23703-2723
US

V. Phone/Fax

Practice location:
  • Phone: 877-848-9810
  • Fax:
Mailing address:
  • Phone: 757-778-0902
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0709026113
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: