| Organization Name: | ERICKA ORTIZ LCPC NBCC PC |
| NPI Number: | 1013373547 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ERICKA MARIE ORTIZ (LCPC) |
| Mailing Address: | 799 Roosevelt Rd Building 4. Suite 101 Glen Ellyn |
| State: | IL US |
| Postal Code: | 601375908 |
| Phone Number: | 7736123537 |
| Fax Number: | |
| NPI Enumeration Date: | 01/13/2016 |
| NPI Last Update Date: | 01/13/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 180005687 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |