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NPI Code Detail

MEDICARE: MS. ERIN COLETTE DIEDLING M.ED., LCPC

MEDICARE:  MS. ERIN COLETTE DIEDLING  M.ED., LCPC
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
1101YM0800XMental Health Counselor178004009IL
2101YP2500XProfessional Counselor180008568IL

General Provider Information

NPI Number : 1174641286
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ERIN COLETTE DIEDLING M.ED., LCPC
Provider Business Mailing Address
First Line : 1926 W ROSCOE
Second Line : #3S
City : CHICAGO
State : IL
Zip : 60657-1051
Country : US
Telephone Number : 773-263-3222
Fax Number : 773-929-6762
Provider Business Practice Location Address
First Line : 3523 N LINCOLN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60657-1137
Country : US
Telephone Number : 773-263-3222
Fax Number : 773-929-6762
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2007
Last Update Date : 08/16/2013

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