Provider Demographics
NPI:1538036967
Name:RUSIEWICZ, ERIC JOSEPH
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:JOSEPH
Last Name:RUSIEWICZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 DORAL CT
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18302-6661
Mailing Address - Country:US
Mailing Address - Phone:610-500-4364
Mailing Address - Fax:
Practice Address - Street 1:95 HIGHLAND AVE STE 301
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-9435
Practice Address - Country:US
Practice Address - Phone:610-849-0413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-21
Last Update Date:2025-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC019481101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional