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NPI Code Detail

MEDICARE: ERICA SAMANTHA DIAZ

MEDICARE: ERICA SAMANTHA DIAZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1629910419
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERICA SAMANTHA DIAZ
Provider Business Mailing Address
First Line : 770 WOODLANE RD
Second Line :
City : WESTAMPTON
State : NJ
Zip : 08060-3804
Country : US
Telephone Number : 609-267-5928
Fax Number :
Provider Business Practice Location Address
First Line : 770 WOODLANE RD
Second Line :
City : WESTAMPTON
State : NJ
Zip : 08060-3804
Country : US
Telephone Number : 609-267-5928
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2026
Last Update Date : 04/08/2026

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Directions to “ ERICA SAMANTHA DIAZ ” Practice Location

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