Active NPI
Marina L Ervin, MS, LPC, NCC, BCPCC
- Professional Counselor
- Greensboro, NC
National Provider Identifier
1790788206
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 3425 LPC
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6102031 | Medicaid | NC | |
| 131AP | Other | NC | BCBS/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
| License | State | Type | Specialty |
|---|---|---|---|
| 3425 LPC | NC | MD | Professional Counselor |
| 47974 NCC | NC | MD | Professional Counselor |
Interoperability endpoints
- 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.