Healthcare Provider Details

I. General information

NPI: 1306243902
Provider Name (Legal Business Name): ERIN VINSKI LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/25/2014
Last Update Date: 11/15/2022
Certification Date: 11/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 OLEVIA ST
JACKSONVILLE FL
32207-3466
US

IV. Provider business mailing address

1900 OLEVIA ST APT 130
JACKSONVILLE FL
32207-3484
US

V. Phone/Fax

Practice location:
  • Phone: 904-401-6017
  • Fax:
Mailing address:
  • Phone: 904-401-6017
  • Fax: 772-675-9100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: