Provider Demographics
NPI:1083470603
Name:ERVIN, ELIZABETH THOMPSON (PMHNP-BC)
Entity type:Individual
Prefix:MISS
First Name:ELIZABETH
Middle Name:THOMPSON
Last Name:ERVIN
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 SCOTT ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-4345
Mailing Address - Country:US
Mailing Address - Phone:843-607-9731
Mailing Address - Fax:
Practice Address - Street 1:208 SCOTT ST
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-4345
Practice Address - Country:US
Practice Address - Phone:843-607-9731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-21
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC290112084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry