MEDICARE: MS. ERIN PAWLAK LPCC

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
1	101YM0800X	Mental Health Counselor	E1100382	OH

General Provider Information

NPI Number	:	1730571969
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ERIN PAWLAK LPCC

Provider Business Mailing Address
First Line	:	8224 MENTOR AVE
Second Line	:	SUITE 208
City	:	MENTOR
State	:	OH
Zip	:	44060-5768
Country	:	US
Telephone Number	:	440-392-2222
Fax Number	:	440-565-2349

Provider Business Practice Location Address
First Line	:	8224 MENTOR AVE
Second Line	:	SUITE 208
City	:	MENTOR
State	:	OH
Zip	:	44060-5768
Country	:	US
Telephone Number	:	440-392-2222
Fax Number	:	440-565-2349

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/25/2015
Last Update Date	:	02/25/2015

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