Provider Demographics
NPI:1275346835
Name:PAGE, ERICA SAMANTHA (MS)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:SAMANTHA
Last Name:PAGE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:SAMANTHA
Other - Last Name:KOLLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:205 INVERNESS CIR
Mailing Address - Street 2:
Mailing Address - City:CHALFONT
Mailing Address - State:PA
Mailing Address - Zip Code:18914-3919
Mailing Address - Country:US
Mailing Address - Phone:267-241-3406
Mailing Address - Fax:
Practice Address - Street 1:866 W BRISTOL RD
Practice Address - Street 2:
Practice Address - City:WARMINSTER
Practice Address - State:PA
Practice Address - Zip Code:18974-2170
Practice Address - Country:US
Practice Address - Phone:215-323-4244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health