Provider Demographics
NPI:1265809164
Name:ERYN SMITH-MOELLER LCPC
Entity type:Organization
Organization Name:ERYN SMITH-MOELLER LCPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERYN
Authorized Official - Middle Name:HEATHER
Authorized Official - Last Name:SMITH-MOELLER
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:708-571-0082
Mailing Address - Street 1:639 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-6643
Mailing Address - Country:US
Mailing Address - Phone:708-571-0082
Mailing Address - Fax:630-428-0069
Practice Address - Street 1:60 HEATHER GLEN DR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-6686
Practice Address - Country:US
Practice Address - Phone:847-660-3393
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-26
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.008898101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty