Provider Demographics
NPI:1881888139
Name:POTTER, ERICA MARIA (LPC)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:MARIA
Last Name:POTTER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1324 W 38TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16508-2462
Mailing Address - Country:US
Mailing Address - Phone:814-835-1700
Mailing Address - Fax:814-835-1701
Practice Address - Street 1:5932 GLADE DR
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16509-2704
Practice Address - Country:US
Practice Address - Phone:413-237-8164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-29
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
PAPC004556101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional