1356094189 NPI number — ERIN MOSES MOTLEY LPC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356094189 NPI number — ERIN MOSES MOTLEY LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MOTLEY
Provider First Name:
ERIN
Provider Middle Name:
MOSES
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MOSES
Provider Other First Name:
ERIN
Provider Other Middle Name:
ONEAL
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1356094189
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/01/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
173 CANTERBURY LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RIDGEWAY
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24148-3309
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
276-732-6336
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
245 HAIRSTON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DANVILLE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24540-4137
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
434-483-2037
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/01/2022

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  0701011166 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0701011166 . This is a "LICENSED NUMBER FOR PROFESSIONAL COUNSELOR" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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