MEDICARE: MS. LUCILLE A DREXLER LPC

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	PC003140	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	255470	OTHER	PA	COM PSYCH

General Provider Information

NPI Number	:	1982671970
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LUCILLE A DREXLER LPC

Provider Business Mailing Address
First Line	:	1371 WEST 6TH STREET
Second Line	:
City	:	ERIE
State	:	PA
Zip	:	16505
Country	:	US
Telephone Number	:	814-456-5035
Fax Number	:

Provider Business Practice Location Address
First Line	:	1371 WEST 6TH STREET
Second Line	:
City	:	ERIE
State	:	PA
Zip	:	16505-2503
Country	:	US
Telephone Number	:	814-456-5035
Fax Number	:

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

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	07/08/2007

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