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General NPI Number Information
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NPI Number | 1487071445
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Entity Type | Organization
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Legal Business Name | ER COUNSELING LLC
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Dates
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Enumeration Date | 03/27/2014
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Last Update Date | 03/27/2014
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Provider Practice Location Address
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Address Line | 54 W BROADWAY ST STE 6
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City | SHELBYVILLE
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State | IN
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Zip | 46176-1267
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Country | US
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Telephone | 812-345-0499
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Fax | 866-793-0495
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Provider Business Mailing Address
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Address Line | 54 W BROADWAY ST STE 6
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City | SHELBYVILLE
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State | IN
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Zip | 46176-1267
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Country | US
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Telephone | 812-345-0499
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Fax | 866-793-0495
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Authorized Official
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Title or Position | PRESIDENT
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Name | VICTORIA ANN HARRIS
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Credential | LCSW, LCAV
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Telephone | 812-345-0499
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 87000018A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 34005767A
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License Number State | IN
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