Healthcare Provider Details

I. General information

NPI: 1891230686
Provider Name (Legal Business Name): ERIN FLICK LCSW, LCAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERIN SKARUPPA

II. Dates (important events)

Enumeration Date: 01/03/2017
Last Update Date: 01/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 MEDIC WAY
GREENCASTLE IN
46135-2296
US

IV. Provider business mailing address

308 MEDIC WAY
GREENCASTLE IN
46135-2296
US

V. Phone/Fax

Practice location:
  • Phone: 888-714-1927
  • Fax: 765-653-8671
Mailing address:
  • Phone: 888-714-1927
  • Fax: 765-653-8671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number87001523A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34006388A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: