Basic Information
Provider Information
NPI: 1437725918
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MUSSETT
FirstName: ERIN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LPC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2185 W 8TH ST
Address2:  
City: ERIE
State: PA
PostalCode: 165054747
CountryCode: US
TelephoneNumber: 8144535806
FaxNumber: 8144648314
Practice Location
Address1: 2910 STATE ST
Address2:  
City: ERIE
State: PA
PostalCode: 165081832
CountryCode: US
TelephoneNumber: 8144535806
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/03/2021
LastUpdateDate: 06/03/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/03/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800XPC010092PAY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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