Provider Demographics
NPI:1245790369
Name:HASSALL, ERIN JOYCE (LMFT)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:JOYCE
Last Name:HASSALL
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 TALAMORA TRL
Mailing Address - Street 2:
Mailing Address - City:BROCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14420-3000
Mailing Address - Country:US
Mailing Address - Phone:585-953-5918
Mailing Address - Fax:
Practice Address - Street 1:85 S UNION ST STE 206A
Practice Address - Street 2:
Practice Address - City:SPENCERPORT
Practice Address - State:NY
Practice Address - Zip Code:14559-1255
Practice Address - Country:US
Practice Address - Phone:585-310-0434
Practice Address - Fax:585-627-0103
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-24
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000351106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty