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General NPI Number Information
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NPI Number | 1295192094
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Entity Type | Individual
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Provider Name | ERICA IRENE ESSARY PSYD, CAADC
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Gender | Female
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Dates
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Enumeration Date | 01/25/2016
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Last Update Date | 06/05/2019
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Provider Practice Location Address
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Address Line | 7717 STEVENS ST
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City | DARIEN
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State | IL
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Zip | 60561-4427
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Country | US
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Telephone | 630-710-2002
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Fax |
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Provider Business Mailing Address
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Address Line | 7717 STEVENS ST
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City | DARIEN
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State | IL
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Zip | 60561-4427
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Country | US
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Telephone | 630-710-2002
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 077188
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071009197
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License Number State | IL
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