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General NPI Number Information
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NPI Number | 1720369614
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Entity Type | Individual
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Provider Name | ERICA B GRACIA-CEDENO LPC
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Gender | Female
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Dates
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Enumeration Date | 09/06/2011
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Last Update Date | 05/23/2013
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Provider Practice Location Address
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Address Line | 865 US HIGHWAY 22
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City | PHILLIPSBURG
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State | NJ
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Zip | 08865
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Country | US
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Telephone | 570-730-2950
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Fax |
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Provider Business Mailing Address
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Address Line | 250 COOLBAUGH RD
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City | EAST STROUDSBURG
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State | PA
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Zip | 18302-9548
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Country | US
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Telephone | 570-730-2950
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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 | 37PC00421000
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License Number State | NJ
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