Provider Demographics
NPI:1679035679
Name:STATES, ERICA JEAN (LPC)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:JEAN
Last Name:STATES
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 1:4003 SALTSBURG RD STE 102
Mailing Address - Street 2:
Mailing Address - City:MURRYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15668-9712
Mailing Address - Country:US
Mailing Address - Phone:814-201-1529
Mailing Address - Fax:
Practice Address - Street 1:4003 SALTSBURG RD STE 102
Practice Address - Street 2:
Practice Address - City:MURRYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15668-9712
Practice Address - Country:US
Practice Address - Phone:814-201-1529
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-01
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC011217101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty