Provider Demographics
NPI:1053143891
Name:CHOICE, ERIN R (MA)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:R
Last Name:CHOICE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7413 EXWICK LN
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23237-1835
Mailing Address - Country:US
Mailing Address - Phone:804-617-7838
Mailing Address - Fax:
Practice Address - Street 1:12801 IRON BRIDGE RD STE 100
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-1669
Practice Address - Country:US
Practice Address - Phone:804-404-3403
Practice Address - Fax:804-895-7868
Is Sole Proprietor?:No
Enumeration Date:2024-08-19
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701013894101YP2500X
VA0704014229101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health