Provider Demographics
NPI:1952810277
Name:ERTL, BARBARA JEANNE (LPC)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:JEANNE
Last Name:ERTL
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:PO BOX 8947
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505-0947
Mailing Address - Country:US
Mailing Address - Phone:814-882-2216
Mailing Address - Fax:
Practice Address - Street 1:2185 W 8TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16505-4747
Practice Address - Country:US
Practice Address - Phone:814-878-2126
Practice Address - Fax:814-878-3448
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-29
Last Update Date:2017-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC0000268101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health