Provider Demographics
NPI:1710225578
Name:KIECHLE, ERIN ASHLEY (LMHC)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:ASHLEY
Last Name:KIECHLE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MS
Other - First Name:ERIN
Other - Middle Name:ASHLEY
Other - Last Name:O'CONNELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:531 WASHINGTON ST STE 4124
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13601-4037
Mailing Address - Country:US
Mailing Address - Phone:315-782-4483
Mailing Address - Fax:315-785-9210
Practice Address - Street 1:31551 COUNTY ROUTE 20
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:NY
Practice Address - Zip Code:13673-2214
Practice Address - Country:US
Practice Address - Phone:315-775-8418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-29
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NY005436101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health