Healthcare Provider Details

I. General information

NPI: 1528584281
Provider Name (Legal Business Name): ERICA COLLISON MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2017
Last Update Date: 11/05/2024
Certification Date: 11/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1410 E MARKET ST
YORK PA
17403-1253
US

IV. Provider business mailing address

1562 FILBERT ST
YORK PA
17404-5202
US

V. Phone/Fax

Practice location:
  • Phone: 717-462-7003
  • Fax:
Mailing address:
  • Phone: 717-818-1147
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPC012750
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: