Provider Demographics
NPI:1073013579
Name:CHAVEZ, ERICA (LPC)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:364 HUNTINGTON CT
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-3439
Mailing Address - Country:US
Mailing Address - Phone:586-243-7175
Mailing Address - Fax:
Practice Address - Street 1:48465 VAN DYKE AVE STE A
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48317-3272
Practice Address - Country:US
Practice Address - Phone:586-243-7175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-20
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401016488101Y00000X
MI6401018392101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor