Provider Demographics
NPI:1033742556
Name:SUROWANIEC, ERICKA (SAC, LPC-IT)
Entity Type:Individual
Prefix:
First Name:ERICKA
Middle Name:
Last Name:SUROWANIEC
Suffix:
Gender:F
Credentials:SAC, LPC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 WISCONSIN AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53186-4946
Mailing Address - Country:US
Mailing Address - Phone:414-301-1518
Mailing Address - Fax:
Practice Address - Street 1:1333 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:SOUTH MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53172-1150
Practice Address - Country:US
Practice Address - Phone:414-775-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-13
Last Update Date:2022-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI19115-130101YA0400X
WI5028-226101YM0800X
WI16532-131101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health