Healthcare Provider Details

I. General information

NPI: 1700522794
Provider Name (Legal Business Name): ERIN LAURA VAHRATIAN LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ERIN LAURA VAHRATIAN LMHC

II. Dates (important events)

Enumeration Date: 05/11/2022
Last Update Date: 09/28/2023
Certification Date: 09/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 MAIN ST
WEST NEWBURY MA
01985-1801
US

IV. Provider business mailing address

171 MAIN ST
WEST NEWBURY MA
01985-1801
US

V. Phone/Fax

Practice location:
  • Phone: 248-722-5304
  • Fax:
Mailing address:
  • Phone: 248-722-5304
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number13106
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: