Healthcare Provider Details

I. General information

NPI: 1023222023
Provider Name (Legal Business Name): ERIN CHRISTINA EGAN LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 09/22/2023
Certification Date: 09/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 PACKARD ST STE 104A
ANN ARBOR MI
48104-6827
US

IV. Provider business mailing address

548 S MAIN ST
ANN ARBOR MI
48104-2921
US

V. Phone/Fax

Practice location:
  • Phone: 734-707-1052
  • Fax: 734-661-1887
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6801085715
License Number StateMI
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: