MEDICARE: ERIN ELIZABETH HAUCK LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	34012560A	IN

General Provider Information

NPI Number	:	1982560157
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN ELIZABETH HAUCK LCSW

Provider Business Mailing Address
First Line	:	2422 E 68TH ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-1317
Country	:	US
Telephone Number	:	317-250-6737
Fax Number	:

Provider Business Practice Location Address
First Line	:	3419 ENGLISH AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46201-4328
Country	:	US
Telephone Number	:	317-880-8491
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/31/2025
Last Update Date	:	12/31/2025

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