Provider Demographics
NPI:1063680452
Name:GABEHART, ERIN L (MA LCPC)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:L
Last Name:GABEHART
Suffix:
Gender:F
Credentials:MA LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 S HONOLULU ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:IL
Mailing Address - Zip Code:62612
Mailing Address - Country:US
Mailing Address - Phone:217-416-1040
Mailing Address - Fax:
Practice Address - Street 1:5230 S 6TH STREET RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62703-5128
Practice Address - Country:US
Practice Address - Phone:217-585-1180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-19
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.007098101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health