Provider Demographics
NPI:1437442258
Name:EHRLICH, VICKI JANE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:VICKI
Middle Name:JANE
Last Name:EHRLICH
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 LOCUST AVE
Mailing Address - Street 2:
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538-3821
Mailing Address - Country:US
Mailing Address - Phone:917-817-3440
Mailing Address - Fax:
Practice Address - Street 1:2039 PALMER AVE STE 204
Practice Address - Street 2:
Practice Address - City:LARCHMONT
Practice Address - State:NY
Practice Address - Zip Code:10538-2483
Practice Address - Country:US
Practice Address - Phone:914-833-3875
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-26
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011376-1103TC2200X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent