Provider Demographics
NPI:1891038865
Name:RIDLEY, ERIN REGINA (NCC, LPC)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:REGINA
Last Name:RIDLEY
Suffix:
Gender:F
Credentials:NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:814 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-6327
Mailing Address - Country:US
Mailing Address - Phone:724-290-1025
Mailing Address - Fax:
Practice Address - Street 1:200 RENAISSANCE DR
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001
Practice Address - Country:US
Practice Address - Phone:724-287-1880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-28
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC006103101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional