Healthcare Provider Details

I. General information

NPI: 1861235103
Provider Name (Legal Business Name): ERICA BONCELLA LPC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2024
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3266 W 26TH ST STE 101
ERIE PA
16506-2508
US

IV. Provider business mailing address

3037 W 42ND ST
ERIE PA
16506-5317
US

V. Phone/Fax

Practice location:
  • Phone: 814-392-8891
  • Fax:
Mailing address:
  • Phone: 814-392-8891
  • 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 Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: ERICA LYN BONCELLA
Title or Position: LPC
Credential: LPC
Phone: 814-392-8891