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General NPI Number Information
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NPI Number | 1437649977
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Entity Type | Individual
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Provider Name | ERICA CORBIN
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Gender | Female
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Dates
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Enumeration Date | 05/10/2018
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Last Update Date | 10/17/2023
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Provider Practice Location Address
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Address Line | 5801 EXECUTIVE CENTER DR STE 200
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City | CHARLOTTE
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State | NC
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Zip | 28212-8897
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Country | US
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Telephone | 704-567-0790
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Fax |
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Provider Business Mailing Address
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Address Line | 100 AUBURN CV
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City | MOUNT HOLLY
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State | NC
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Zip | 28120-8107
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Country | US
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Telephone | 704-601-6652
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | A13939
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | A13939
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | A13939
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License Number State | NC
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