Provider Demographics
NPI:1952340614
Name:ERVIN, MARGARET C (LCSW, BCD)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:C
Last Name:ERVIN
Suffix:
Gender:F
Credentials:LCSW, BCD
Other - Prefix:
Other - First Name:MARGO
Other - Middle Name:
Other - Last Name:ERVIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW,BCD
Mailing Address - Street 1:112 BARKSIDE LN
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-8541
Mailing Address - Country:US
Mailing Address - Phone:252-633-1965
Mailing Address - Fax:
Practice Address - Street 1:210 STONEBRIDGE SQ
Practice Address - Street 2:
Practice Address - City:HAVELOCK
Practice Address - State:NC
Practice Address - Zip Code:28532-9505
Practice Address - Country:US
Practice Address - Phone:252-636-5277
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0025921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6002335Medicaid
NC30789OtherBCBS
NC30789OtherBCBS