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General NPI Number Information
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NPI Number | 1265809164
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Entity Type | Organization
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Legal Business Name | ERYN SMITH-MOELLER LCPC
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Dates
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Enumeration Date | 08/26/2015
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Last Update Date | 08/26/2015
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Provider Practice Location Address
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Address Line | 60 HEATHER GLEN DR
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City | AURORA
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State | IL
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Zip | 60504-6686
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Country | US
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Telephone | 847-660-3393
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Fax |
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Provider Business Mailing Address
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Address Line | 639 S WASHINGTON ST
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City | NAPERVILLE
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State | IL
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Zip | 60540-6643
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Country | US
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Telephone | 708-571-0082
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Fax | 630-428-0069
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | MRS. ERYN HEATHER SMITH-MOELLER
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Credential | LCPC
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Telephone | 708-571-0082
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180.008898
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License Number State | IL
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