Healthcare Provider Details

I. General information

NPI: 1265498794
Provider Name (Legal Business Name): ROBERT J DAY MS, LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2006
Last Update Date: 02/19/2020
Certification Date: 02/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 PARADE STREET, UNIT B UNIT B
ERIE PA
16507
US

IV. Provider business mailing address

503 PARADE STREET, UNIT B UNIT B
ERIE PA
16507
US

V. Phone/Fax

Practice location:
  • Phone: 814-838-2282
  • Fax: 814-838-1091
Mailing address:
  • Phone: 814-838-2282
  • Fax: 814-838-1091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCAC NUMBER 4355
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC000605
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: