Healthcare Provider Details

I. General information

NPI: 1124627658
Provider Name (Legal Business Name): ERICA L DANIELS, PCC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2020
Last Update Date: 10/26/2020
Certification Date: 10/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 JEFFERSON AVE
CINCINNATI OH
45215-3236
US

IV. Provider business mailing address

258 STEEPLECHASE LN
MONROE OH
45050-2441
US

V. Phone/Fax

Practice location:
  • Phone: 513-268-5828
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MS. ERICA DANIELS
Title or Position: OWNER
Credential: LPCC-S
Phone: 513-268-5828