Healthcare Provider Details

I. General information

NPI: 1477988079
Provider Name (Legal Business Name): ERIN M GATES LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2013
Last Update Date: 03/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 E MOUNT HOPE AVE UPPR LEVEL
LANSING MI
48910-3279
US

IV. Provider business mailing address

PO BOX 30161
LANSING MI
48909-7661
US

V. Phone/Fax

Practice location:
  • Phone: 517-267-3400
  • Fax: 517-372-9188
Mailing address:
  • Phone: 517-887-4467
  • Fax: 517-244-7174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6801094948
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: