Provider Demographics
NPI:1669011615
Name:WALECKA, ERICA N (MDIV, LPC, NCC)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:N
Last Name:WALECKA
Suffix:
Gender:
Credentials:MDIV, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19590 E MAINSTREET STE 202
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-7371
Mailing Address - Country:US
Mailing Address - Phone:520-230-2449
Mailing Address - Fax:
Practice Address - Street 1:10501 E SEVEN GENERATIONS WAY STE 121
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85747-5828
Practice Address - Country:US
Practice Address - Phone:520-214-8650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-21
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-18713101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor