Provider Demographics
NPI:1487071445
Name:ER COUNSELING LLC
Entity type:Organization
Organization Name:ER COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LCAV
Authorized Official - Phone:812-345-0499
Mailing Address - Street 1:54 W BROADWAY ST STE 6
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46176-1267
Mailing Address - Country:US
Mailing Address - Phone:812-345-0499
Mailing Address - Fax:866-793-0495
Practice Address - Street 1:54 W BROADWAY ST STE 6
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:IN
Practice Address - Zip Code:46176-1267
Practice Address - Country:US
Practice Address - Phone:812-345-0499
Practice Address - Fax:866-793-0495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-27
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN87000018A251S00000X
IN34005767A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
INM300033480Medicare PIN