Provider Demographics
NPI:1659928968
Name:NKELE, ERIN (LCPC, LPC)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:NKELE
Suffix:
Gender:F
Credentials:LCPC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 TRAVIS LN
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20879-3217
Mailing Address - Country:US
Mailing Address - Phone:858-722-9906
Mailing Address - Fax:
Practice Address - Street 1:12 S SUMMIT AVE STE 100
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-2090
Practice Address - Country:US
Practice Address - Phone:240-720-7817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-21
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC10985101YP2500X
DCPRC200002074101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional