Healthcare Provider Details

I. General information

NPI: 1609313964
Provider Name (Legal Business Name): ERIN COLLEEN HODGE-WILLIAMS LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ERIN COLLEEN COLEMAN LCSW-C

II. Dates (important events)

Enumeration Date: 01/25/2017
Last Update Date: 01/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8415 BELLONA LN SUITE 203
TOWSON MD
21204-2055
US

IV. Provider business mailing address

8415 BELLONA LN SUITE 203
TOWSON MD
21204-2055
US

V. Phone/Fax

Practice location:
  • Phone: 410-777-8151
  • Fax: 410-821-1816
Mailing address:
  • Phone: 410-777-8151
  • Fax: 410-821-1816

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number09176
License Number StateMD

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: