Provider Demographics
NPI:1700495462
Name:MONFISTON, ERIN (LCPC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:MONFISTON
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3175 W WARD RD STE 200
Mailing Address - Street 2:
Mailing Address - City:DUNKIRK
Mailing Address - State:MD
Mailing Address - Zip Code:20754-3024
Mailing Address - Country:US
Mailing Address - Phone:410-286-0664
Mailing Address - Fax:410-286-2834
Practice Address - Street 1:3175 W WARD RD STE 200
Practice Address - Street 2:
Practice Address - City:DUNKIRK
Practice Address - State:MD
Practice Address - Zip Code:20754-3024
Practice Address - Country:US
Practice Address - Phone:410-286-0664
Practice Address - Fax:410-286-2834
Is Sole Proprietor?:No
Enumeration Date:2020-07-29
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP10532101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional