MEDICARE: DR. ERIK SPROHGE PHD

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	103T00000X	Psychologist	PS015465	PA
2	103TC0700X	Clinical Psychologist	PS015465	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	SP1551024	OTHER	PR	PA BLUE SHIELD
2	503216	OTHER	PA	VALUE OPTIONS
3	621278	OTHER	PA	BC/BS OF MD. CARE FIRST
4	488512000	OTHER	PA	MAGELLAN
5	50026502	OTHER	PA	CAPITAL BLUE CROSS
6	3119426	OTHER	PA	MAMSI
7	2181281	OTHER	PA	CIGNA BEHAVIORAL HEALTH

General Provider Information

NPI Number	:	1932135753
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIK SPROHGE PHD

Provider Business Mailing Address
First Line	:	1803 MT ROSE AVE
Second Line	:	STE B3
City	:	YORK
State	:	PA
Zip	:	17403-3051
Country	:	US
Telephone Number	:	717-851-1405
Fax Number	:	717-812-2569

Provider Business Practice Location Address
First Line	:	781 FAR HILLS DR
Second Line	:	SUITE 600
City	:	NEW FREEDOM
State	:	PA
Zip	:	17349-9346
Country	:	US
Telephone Number	:	717-812-2560
Fax Number	:	717-812-2569

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

Provider Enumeration Date	:	06/23/2006
Last Update Date	:	04/02/2012

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Directions to “ DR. ERIK SPROHGE PHD” Practice Location

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