Provider Demographics
NPI:1932135753
Name:SPROHGE, ERIK (PHD)
Entity Type:Individual
Prefix:DR
First Name:ERIK
Middle Name:
Last Name:SPROHGE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1803 MT ROSE AVE
Mailing Address - Street 2:STE B3
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3051
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:717-812-2569
Practice Address - Street 1:781 FAR HILLS DR
Practice Address - Street 2:SUITE 600
Practice Address - City:NEW FREEDOM
Practice Address - State:PA
Practice Address - Zip Code:17349-9346
Practice Address - Country:US
Practice Address - Phone:717-812-2560
Practice Address - Fax:717-812-2569
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS015465103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRSP1551024OtherPA BLUE SHIELD
PA503216OtherVALUE OPTIONS
PA621278OtherBC/BS OF MD. CARE FIRST
PA488512000OtherMAGELLAN
PA50026502OtherCAPITAL BLUE CROSS
PA3119426OtherMAMSI
PA2181281OtherCIGNA BEHAVIORAL HEALTH
PRSP1551024OtherPA BLUE SHIELD
PA083322Medicare PIN