Individual provider Active NPI

Marina L Ervin, MS, LPC, NCC, BCPCC

  • Professional Counselor
  • Greensboro, NC
National Provider Identifier
1790788206
Registry record updated Oct 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
3425 LPC Issued in NC
Practice address
502N East Cornwallis Dr
Ste B
Greensboro, NC 27405-5677
Phone
(336) 681-1086
Fax
(336) 370-0257
NPI assigned
May 30, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 47974 NCC NC
Professional Counselor 101YP2500X 3425 LPC NC Primary

Addresses

Primary practice location

502N East Cornwallis Dr
Ste B
Greensboro, NC 27405-5677

Mailing address

502N East Cornwallis Dr
Ste B
Greensboro, NC 27405-5677
Phone (336) 681-1086

Other identifiers 2

IdentifierTypeStateIssuer
6102031MedicaidNC
131APOtherNCBCBS/NC HEALTH CHOICE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
3425 LPCNCMDProfessional Counselor
47974 NCCNCMDProfessional Counselor

Interoperability endpoints

  • Direct secure messaging: marina.erwin@direct.marinaervin.nchie.net

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1117411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193702400000",
    "number": "1790788206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502N EAST CORNWALLIS DR",
            "address_2": "STE B",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274055677",
            "telephone_number": "336-681-1086",
            "fax_number": "336-370-0257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502N EAST CORNWALLIS DR",
            "address_2": "STE B",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274055677",
            "telephone_number": "336-681-1086",
            "fax_number": "336-370-0257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERVIN",
        "first_name": "MARINA",
        "middle_name": "L",
        "credential": "MS, LPC, NCC, BCPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-05-30",
        "last_updated": "2007-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "47974 NCC",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "3425 LPC",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6102031",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS/NC HEALTH CHOICE",
            "identifier": "131AP",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.