Provider Demographics
NPI:1821819053
Name:BROPHY, ERIN (LAC)
Entity type:Individual
Prefix:MS
First Name:ERIN
Middle Name:
Last Name:BROPHY
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 BRICK BLVD STE 307
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-6080
Mailing Address - Country:US
Mailing Address - Phone:732-546-6638
Mailing Address - Fax:
Practice Address - Street 1:445 BRICK BLVD STE 307
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-6080
Practice Address - Country:US
Practice Address - Phone:848-287-3882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00735300101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health