Provider Demographics
NPI:1346389574
Name:FOX, ERIACH DANIEL (LPC, LCADC)
Entity Type:Individual
Prefix:
First Name:ERIACH
Middle Name:DANIEL
Last Name:FOX
Suffix:
Gender:M
Credentials:LPC, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:826 WILDER ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-5714
Mailing Address - Country:US
Mailing Address - Phone:215-469-1932
Mailing Address - Fax:
Practice Address - Street 1:1625 SOUTH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19146-1541
Practice Address - Country:US
Practice Address - Phone:215-469-1932
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC013914101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health