Provider Demographics
NPI:1063872257
Name:RAYBURN, ERIN (LMFT, LPC-MHSP, NCC)
Entity type:Individual
Prefix:MS
First Name:ERIN
Middle Name:
Last Name:RAYBURN
Suffix:
Gender:F
Credentials:LMFT, LPC-MHSP, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 311
Mailing Address - Street 2:
Mailing Address - City:LOOKOUT MOUNTAIN
Mailing Address - State:TN
Mailing Address - Zip Code:37350-0311
Mailing Address - Country:US
Mailing Address - Phone:423-364-9955
Mailing Address - Fax:
Practice Address - Street 1:748 OVERBRIDGE LN STE 12
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37405-3320
Practice Address - Country:US
Practice Address - Phone:423-364-9955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-01
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3198101YM0800X
TN966106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health