Healthcare Provider Details

I. General information

NPI: 1366116022
Provider Name (Legal Business Name): ERICA DAWN MULLER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2021
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 MAPLE ST
TERRYVILLE CT
06786-5220
US

IV. Provider business mailing address

36 TODD HOLLOW RD
PLYMOUTH CT
06782-2321
US

V. Phone/Fax

Practice location:
  • Phone: 203-232-5971
  • Fax:
Mailing address:
  • Phone: 860-620-7223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number7485
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number82981
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number82981
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: