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NPI Code Detail

MEDICARE: ERICA GAD CT

MEDICARE: ERICA GAD CT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor
2101YP2500XProfessional CounselorC.2406360-TRNEOH

General Provider Information

NPI Number : 1063229623
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERICA GAD CT
Provider Business Mailing Address
First Line : 3095 KETTERING BLVD
Second Line :
City : MORAINE
State : OH
Zip : 45439-1983
Country : US
Telephone Number : 937-293-8300
Fax Number :
Provider Business Practice Location Address
First Line : 10861 YANKEE ST
Second Line :
City : CENTERVILLE
State : OH
Zip : 45458-3574
Country : US
Telephone Number : 937-619-0800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2024
Last Update Date : 04/15/2025

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