Provider Demographics
NPI:1316222359
Name:VAN LEUVEN, ERICA JANE I (LCPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:JANE
Last Name:VAN LEUVEN
Suffix:I
Gender:F
Credentials:LCPC, NCC
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:JANE
Other - Last Name:OHMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:740 WARM SPRINGS AVE
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83712-6420
Mailing Address - Country:US
Mailing Address - Phone:208-343-7797
Mailing Address - Fax:208-343-0064
Practice Address - Street 1:740 WARM SPRINGS AVE
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83712-6420
Practice Address - Country:US
Practice Address - Phone:208-343-7797
Practice Address - Fax:208-343-0064
Is Sole Proprietor?:No
Enumeration Date:2011-10-20
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC - 4849101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional