Healthcare Provider Details

I. General information

NPI: 1790286052
Provider Name (Legal Business Name): RENEE BETH PLYLER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RENEE BETH YORK LSW

II. Dates (important events)

Enumeration Date: 02/22/2018
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3910 CAUGHEY RD STE 200
ERIE PA
16506-4098
US

IV. Provider business mailing address

460 LEDWICK DR
ERIE PA
16511-2622
US

V. Phone/Fax

Practice location:
  • Phone: 814-460-9966
  • Fax:
Mailing address:
  • Phone: 814-460-9966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberCW026588
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: