Provider Demographics
NPI:1164005427
Name:TAYLOR, ERICA (MA, LPC, NCC)
Entity type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:MISS
Other - First Name:ERICA
Other - Middle Name:
Other - Last Name:AHLSTROM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LPC, NCC
Mailing Address - Street 1:1502 N LINDEN ST
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47303-2857
Mailing Address - Country:US
Mailing Address - Phone:724-255-8882
Mailing Address - Fax:
Practice Address - Street 1:1502 N LINDEN ST
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47303-2857
Practice Address - Country:US
Practice Address - Phone:724-255-8882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-04
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC013277101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional