Provider Demographics
NPI:1497374235
Name:VAN POPPEL, ERIKA DAWN (LPC)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:DAWN
Last Name:VAN POPPEL
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 1:11967 SWAN VIEW DR
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:MI
Mailing Address - Zip Code:49230-8527
Mailing Address - Country:US
Mailing Address - Phone:517-358-0529
Mailing Address - Fax:
Practice Address - Street 1:11967 SWAN VIEW DR
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:MI
Practice Address - Zip Code:49230-8527
Practice Address - Country:US
Practice Address - Phone:517-358-0529
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-12
Last Update Date:2020-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401008387101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional