Provider Demographics
NPI:1154595759
Name:URQUIAGA, ERINN DENISE (LCPC)
Entity type:Individual
Prefix:
First Name:ERINN
Middle Name:DENISE
Last Name:URQUIAGA
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:688 N BEACHWOOD ST
Mailing Address - Street 2:
Mailing Address - City:EAGLE
Mailing Address - State:ID
Mailing Address - Zip Code:83616-5046
Mailing Address - Country:US
Mailing Address - Phone:208-420-7311
Mailing Address - Fax:
Practice Address - Street 1:688 N BEACHWOOD ST
Practice Address - Street 2:
Practice Address - City:EAGLE
Practice Address - State:ID
Practice Address - Zip Code:83616-5046
Practice Address - Country:US
Practice Address - Phone:208-420-7311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-15
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC-360101YS0200X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool