Healthcare Provider Details

I. General information

NPI: 1144073545
Provider Name (Legal Business Name): STEPHANIE ERINLE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2024
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7530 METROPOLITAN AVE STE 102
MIDDLE VILLAGE NY
11379-2644
US

IV. Provider business mailing address

19011 HILLSIDE AVE APT 501
HOLLIS NY
11423-1950
US

V. Phone/Fax

Practice location:
  • Phone: 631-758-8290
  • Fax:
Mailing address:
  • Phone: 301-906-3877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: