Provider Demographics
NPI:1639320872
Name:BALCH, ERICA K (LPC, LCADC)
Entity Type:Individual
Prefix:MS
First Name:ERICA
Middle Name:K
Last Name:BALCH
Suffix:
Gender:F
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 1:57 CEDAR LN
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-4444
Mailing Address - Country:US
Mailing Address - Phone:201-497-0380
Mailing Address - Fax:201-326-6509
Practice Address - Street 1:57 CEDAR LN
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4444
Practice Address - Country:US
Practice Address - Phone:201-497-0380
Practice Address - Fax:201-326-6509
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-07
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00150300101YA0400X
NJ37PC00341100101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)