Provider Demographics
NPI:1770352395
Name:SPOALES, ERIN MARIE (LGPC)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:MARIE
Last Name:SPOALES
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3409A URBANA PIKE STE 2A
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21704-7794
Mailing Address - Country:US
Mailing Address - Phone:443-788-4266
Mailing Address - Fax:
Practice Address - Street 1:3409A URBANA PIKE STE 2A
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21704-7794
Practice Address - Country:US
Practice Address - Phone:443-788-4266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-22
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP14684101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional