Provider Demographics
NPI:1871477448
Name:ERVIN, WYANDOTTA MICHELLE (LMHC-A)
Entity type:Individual
Prefix:
First Name:WYANDOTTA
Middle Name:MICHELLE
Last Name:ERVIN
Suffix:
Gender:F
Credentials:LMHC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 W MILLBROOK RD STE 210
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-4490
Mailing Address - Country:US
Mailing Address - Phone:984-339-1168
Mailing Address - Fax:
Practice Address - Street 1:207 W MILLBROOK RD STE 210
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-4490
Practice Address - Country:US
Practice Address - Phone:984-339-1168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA21819101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health