Provider Demographics
NPI:1164695649
Name:DANIELS, ERICA L (LPCC-S)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:L
Last Name:DANIELS
Suffix:
Gender:F
Credentials:LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 OLD CARRIAGE CT
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:OH
Mailing Address - Zip Code:45050-2418
Mailing Address - Country:US
Mailing Address - Phone:513-360-8118
Mailing Address - Fax:
Practice Address - Street 1:6923 DUTCHLAND PKWY
Practice Address - Street 2:
Practice Address - City:LIBERTY TWP
Practice Address - State:OH
Practice Address - Zip Code:45044-9029
Practice Address - Country:US
Practice Address - Phone:513-779-7775
Practice Address - Fax:513-779-7389
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-07
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0601020-SUPV101Y00000X
OHE. 0601020101YP2500X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0154737Medicaid