ERICA CHARELLE MANGRUM
NPI 1083419881
Counselor - Professional in Brodnax, VA
Active since February 17, 2025
About Erica Charelle Mangrum NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ERICA CHARELLE MANGRUM (NPI 1083419881) is an individual professional provider in Brodnax, Virginia, licensed in Virginia (0701012779) and active in the NPI registry since February 2025.
NPPES Registry Identity
NPI1083419881
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameERICA CHARELLE MANGRUM
Location Address74 PINE HILL CTBrodnax, VA 23920-3330
Mailing Address74 Pine Hill CtBrodnax, VA 23920-3330 · (434) 637-0914
Phone(434) 637-0914
Sole ProprietorYes
Enumeration DateFebruary 17, 2025
NPPES CertifiedFebruary 16, 2025
✔ NPI 1083419881 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in VA · 0701012779
74 PINE HILL CT, Brodnax, VA 23920
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1083419881, enumerated as an "individual" on February 17, 2025.
The provider is located at 74 PINE HILL CT BRODNAX, VA 23920 and the phone number is (434) 637-0914.
Counselor with taxonomy code 101YP2500X and a focus in Professional.
