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General NPI Number Information
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NPI Number | 1487608501
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Entity Type | Individual
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Provider Name | GERALD ERDELY LPC
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Gender | Male
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Dates
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Enumeration Date | 05/22/2006
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Last Update Date | 05/22/2019
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Provider Practice Location Address
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Address Line | 206 W 11TH ST STE 206A
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City | ERIE
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State | PA
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Zip | 16501-1755
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Country | US
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Telephone | 814-456-5035
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Fax | 814-725-0707
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Provider Business Mailing Address
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Address Line | 1371 W 6TH ST
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City | ERIE
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State | PA
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Zip | 16505-2503
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Country | US
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Telephone | 814-456-5035
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC002088
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License Number State | PA
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