Provider Demographics
NPI:1528077278
Name:ERWIN, ELIZABETH MOWLES (LPC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MOWLES
Last Name:ERWIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:PROF
Other - First Name:ELIZABETH
Other - Middle Name:MOWLES
Other - Last Name:ERWIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:328 MOUNTAIN AVE SW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24016-4004
Mailing Address - Country:US
Mailing Address - Phone:540-345-5922
Mailing Address - Fax:540-345-5712
Practice Address - Street 1:328 MOUNTAIN AVE SW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24016-4004
Practice Address - Country:US
Practice Address - Phone:540-345-5922
Practice Address - Fax:540-345-5712
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002113101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA086394OtherSENTARA
VA077322OtherOPTIONS
VA7202124OtherAETNA
VA045444OtherANTHEM
VA215379OtherVALUE OPTIONS
VA5401887Medicaid
VA209708OtherMANAGED HEALTH NETWORK
VA242378OtherMAMSI
VAP499628OtherPHCS