Provider Demographics
NPI:1780074526
Name:KILPATRICK, ERIN PEARCE (MED, MA, LPC)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:PEARCE
Last Name:KILPATRICK
Suffix:
Gender:F
Credentials:MED, MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2008 HOWELL WALK
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096
Mailing Address - Country:US
Mailing Address - Phone:734-635-6401
Mailing Address - Fax:
Practice Address - Street 1:4842 LAKERIDGE ST APT 1A
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-1409
Practice Address - Country:US
Practice Address - Phone:734-635-6401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-02
Last Update Date:2017-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC008967101YP2500X
GA666521101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional