Healthcare Provider Details

I. General information

NPI: 1457405391
Provider Name (Legal Business Name): LAWRENCE ERHARDT LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28208 STATE ROUTE 1
WEST HARRISON IN
47060-9686
US

IV. Provider business mailing address

285 BIELBY RD
LAWRENCEBURG IN
47025-1055
US

V. Phone/Fax

Practice location:
  • Phone: 812-576-1600
  • Fax:
Mailing address:
  • Phone: 812-537-1302
  • Fax: 812-537-2519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number70000188A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: