Provider Demographics
NPI:1477023562
Name:SCHWARTZ, ERICA
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:
Other - Last Name:ROTHBURD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18278 TECHNOLOGY DR
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-8380
Mailing Address - Country:US
Mailing Address - Phone:814-332-0095
Mailing Address - Fax:814-746-3994
Practice Address - Street 1:18278 TECHNOLOGY DR
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-8380
Practice Address - Country:US
Practice Address - Phone:814-795-9351
Practice Address - Fax:814-746-3994
Is Sole Proprietor?:No
Enumeration Date:2018-11-30
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005223101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health