Provider Demographics
NPI:1881755478
Name:KROLAK, ERICA A (LMHC, NCC)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:A
Last Name:KROLAK
Suffix:
Gender:F
Credentials:LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4949 PLEASANT ST STE 203
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-5495
Mailing Address - Country:US
Mailing Address - Phone:515-575-2102
Mailing Address - Fax:
Practice Address - Street 1:4949 PLEASANT ST STE 203
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-5495
Practice Address - Country:US
Practice Address - Phone:515-575-2102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001012101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty