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Individual
MR. ILYA ERENBERG
Active
Individual
MR. ILYA ERENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A.
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
101YP1600X
Pastoral Counselor
—
—
101YP2500X
Professional Counselor
—
—
101YS0200X
School Counselor
—
—
103T00000X
Psychologist
—
—
Other
Enumeration date
08/05/2007
Last updated
08/05/2007
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