Provider Demographics
NPI:1598509382
Name:TORY ERVIN LMFT LLC
Entity type:Organization
Organization Name:TORY ERVIN LMFT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TORY
Authorized Official - Middle Name:
Authorized Official - Last Name:ERVIN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:864-214-5490
Mailing Address - Street 1:109 LAURENS RD STE 4D
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-1860
Mailing Address - Country:US
Mailing Address - Phone:864-214-5490
Mailing Address - Fax:
Practice Address - Street 1:109 LAURENS RD STE 4D
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-1860
Practice Address - Country:US
Practice Address - Phone:864-214-5490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1659912285OtherNPPES