Healthcare Provider Details

I. General information

NPI: 1609443795
Provider Name (Legal Business Name): ERIKA MARRER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2021
Last Update Date: 06/23/2022
Certification Date: 02/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

269 MEDICAL PARK BLVD
PETERSBURG VA
23805-9337
US

IV. Provider business mailing address

269 MEDICAL PARK BLVD
PETERSBURG VA
23805-9337
US

V. Phone/Fax

Practice location:
  • Phone: 804-861-0700
  • Fax:
Mailing address:
  • Phone: 804-861-0700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0701010539
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: