Provider Demographics
NPI:1962042978
Name:PHILLIPS, ERIN NICOLE (MA, LPC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:NICOLE
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 ELM ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH AMHERST
Mailing Address - State:OH
Mailing Address - Zip Code:44001-3048
Mailing Address - Country:US
Mailing Address - Phone:440-242-8593
Mailing Address - Fax:
Practice Address - Street 1:225 COURT ST
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-5512
Practice Address - Country:US
Practice Address - Phone:440-329-5790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-08
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health