Provider Demographics
NPI:1568733426
Name:WALTZ, ERIN CORTNEY (MS, NCC, LPC)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:CORTNEY
Last Name:WALTZ
Suffix:
Gender:F
Credentials:MS, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 DELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-3506
Mailing Address - Country:US
Mailing Address - Phone:215-353-3796
Mailing Address - Fax:
Practice Address - Street 1:160 S PROGRESS AVE
Practice Address - Street 2:SUITE 1C
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-4636
Practice Address - Country:US
Practice Address - Phone:717-765-7020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-24
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004233101Y00000X, 101YM0800X, 101YP2500X, 101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool