Provider Demographics
NPI:1760464879
Name:PLOSKI, ERICA LYNN (LPC)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:LYNN
Last Name:PLOSKI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:LYNN
Other - Last Name:TIETZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:924 DIAMOND PARK
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-2605
Mailing Address - Country:US
Mailing Address - Phone:814-333-8733
Mailing Address - Fax:814-333-8733
Practice Address - Street 1:924 DIAMOND PARK
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-2605
Practice Address - Country:US
Practice Address - Phone:814-333-8733
Practice Address - Fax:814-333-8733
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-15
Last Update Date:2015-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC000870101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
551050OtherVALUE OPTIONS
1767576OtherHIGHMARK KHPW