Provider Demographics
NPI:1205199791
Name:BROSIG, ERIKA B (LCSW, CTTS)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:B
Last Name:BROSIG
Suffix:
Gender:F
Credentials:LCSW, CTTS
Other - Prefix:
Other - First Name:ERIKA
Other - Middle Name:B
Other - Last Name:JUGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:638 FERNDALE AVE
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15905-3946
Mailing Address - Country:US
Mailing Address - Phone:814-288-4961
Mailing Address - Fax:814-288-3904
Practice Address - Street 1:638 FERNDALE AVE
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15905-3946
Practice Address - Country:US
Practice Address - Phone:814-288-4961
Practice Address - Fax:814-288-3904
Is Sole Proprietor?:No
Enumeration Date:2012-06-19
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0201051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical