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MRS. MARY RUDOLPH
NPI 1174910855
Counselor - Mental Health in Erie, PA

Active since April 21, 2015
4190 E LAKE RD, ERIE, PA 16511(814) 616-2858(814) 616-2860 Get Directions Write a Review

NPPES record last updated: February 18, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Feb 18, 2019, Aug 7, 2018 (2 updates tracked since 2018).

About Mrs. Mary Rudolph NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. MARY RUDOLPH (NPI 1174910855) is an individual mental health provider in Erie, Pennsylvania, licensed in (CW019986) and active in the NPI registry since April 2015.

NPPES Registry Identity

NPI1174910855
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameMRS. MARY RUDOLPH
Location Address4190 E LAKE RDErie, PA 16511
Mailing Address4190 E Lake RdErie, PA 16511-1355 · (814) 616-2858 · Fax (814) 616-2860
Phone(814) 616-2858
Fax(814) 616-2860
Sole ProprietorYes
Enumeration DateApril 21, 2015
Last NPPES UpdateFebruary 18, 20192 updates tracked since enumeration
✔ NPI 1174910855 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed · CW019986
4190 E LAKE RD, Erie, PA 16511
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Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MINDBODYSOULWORKS, LLC
Clinic/Center (Mental Health (Including Community Mental Health Center))
4190 E LAKE RD
ERIE, PA 16511
Erie County (814) 616-2858
DR. STEVEN DANIEL KRAUZA D.C.
Chiropractor
4190 E LAKE RD
ERIE, PA 16511
Erie County (814) 898-2346
KRAUZA FAMILY CHIROPRACTIC, INC
Chiropractor
4190 E LAKE RD
ERIE, PA 16511
Erie County (814) 898-2346

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary Rudolph's NPI number?

The NPI number for Mary Rudolph is 1174910855. It was assigned to this individual provider in the NPPES registry on April 21, 2015.

Where is Mary Rudolph located?

Mary Rudolph practices at 4190 E Lake Rd, Erie, PA 16511. The listed phone number is (814) 616-2858.

What is Mary Rudolph's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Mary Rudolph was last updated on February 18, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.