Provider Demographics
NPI:1790700177
Name:BALTRINIC, ERIC R (LPCC, LICDC)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:R
Last Name:BALTRINIC
Suffix:
Gender:M
Credentials:LPCC, LICDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3929 EDISON ST NW
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-8905
Mailing Address - Country:US
Mailing Address - Phone:330-807-1910
Mailing Address - Fax:
Practice Address - Street 1:3469 FORTUNA DR
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312-5281
Practice Address - Country:US
Practice Address - Phone:330-644-3469
Practice Address - Fax:330-644-8519
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0005769101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor