Provider Demographics
NPI:1023424629
Name:ERBACHER, AILEEN (LICDC-CS, LPCC-S)
Entity type:Individual
Prefix:
First Name:AILEEN
Middle Name:
Last Name:ERBACHER
Suffix:
Gender:F
Credentials:LICDC-CS, LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 N. BARRON ST.
Mailing Address - Street 2:
Mailing Address - City:EATON
Mailing Address - State:OH
Mailing Address - Zip Code:45320
Mailing Address - Country:US
Mailing Address - Phone:937-456-3443
Mailing Address - Fax:
Practice Address - Street 1:225 N. BARRON ST.
Practice Address - Street 2:
Practice Address - City:EATON
Practice Address - State:OH
Practice Address - Zip Code:45320
Practice Address - Country:US
Practice Address - Phone:937-456-3443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-03
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH892620101YA0400X
OHE0001690101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)