MEDICARE: ERIN HEALY ENNIS LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1194287227
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN HEALY ENNIS LMFT

Provider Business Mailing Address
First Line	:	890 S KERR AVE STE 250
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28403-2573
Country	:	US
Telephone Number	:	706-306-7471
Fax Number	:

Provider Business Practice Location Address
First Line	:	890 S KERR AVE STE 250
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28403-2573
Country	:	US
Telephone Number	:	706-306-7471
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2019
Last Update Date	:	11/19/2024

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Directions to “ ERIN HEALY ENNIS LMFT” Practice Location

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