MEDICARE: MS. ERIN MARCHANT MUSSON LCSW

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	1041C0700X	Clinical Social Worker	P010236	NC

General Provider Information

NPI Number	:	1952756082
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ERIN MARCHANT MUSSON LCSW

Provider Business Mailing Address
First Line	:	100 RENEE LYNN CT
Second Line	:
City	:	CARRBORO
State	:	NC
Zip	:	27510-6511
Country	:	US
Telephone Number	:	919-966-5693
Fax Number	:	919-966-4003

Provider Business Practice Location Address
First Line	:	CB 6305 UNIVERSITY OF NORTH CAROLINA
Second Line	:
City	:	CHAPEL HILL
State	:	NC
Zip	:	27599-6305
Country	:	US
Telephone Number	:	919-966-5693
Fax Number	:

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

Provider Enumeration Date	:	04/26/2016
Last Update Date	:	04/26/2016

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