Provider Demographics
NPI:1326047135
Name:PLANK, ERICA (LPC)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:PLANK
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 1:1126 S COLGATE CT
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65802-5179
Mailing Address - Country:US
Mailing Address - Phone:417-862-5864
Mailing Address - Fax:417-862-5864
Practice Address - Street 1:23271 LAWRENCE 2170
Practice Address - Street 2:FAMILY CENTERED COUNSELING
Practice Address - City:MARIONVILLE
Practice Address - State:MO
Practice Address - Zip Code:65705-8254
Practice Address - Country:US
Practice Address - Phone:417-840-7354
Practice Address - Fax:417-862-5864
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002010856101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional