Provider Demographics
NPI:1790032811
Name:GREENSPAN, ERIN LEIGH (MA, LAC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:LEIGH
Last Name:GREENSPAN
Suffix:
Gender:F
Credentials:MA, LAC
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:LEIGH
Other - Last Name:DEVRIES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LAC
Mailing Address - Street 1:209 COMLY RD
Mailing Address - Street 2:APT. C30
Mailing Address - City:LINCOLN PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07035-1126
Mailing Address - Country:US
Mailing Address - Phone:973-985-7173
Mailing Address - Fax:
Practice Address - Street 1:209 COMLY RD
Practice Address - Street 2:APT. C30
Practice Address - City:LINCOLN PARK
Practice Address - State:NJ
Practice Address - Zip Code:07035-1126
Practice Address - Country:US
Practice Address - Phone:973-985-7173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-08
Last Update Date:2013-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional