Healthcare Provider Details

I. General information

NPI: 1184914475
Provider Name (Legal Business Name): ERIN KRAMER POOLE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2011
Last Update Date: 02/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 LAUREL AVE SUITE 290
CORNWALL NY
12518-1469
US

IV. Provider business mailing address

424 CARPENTER AVE APT 3
NEWBURGH NY
12550-3321
US

V. Phone/Fax

Practice location:
  • Phone: 845-458-4558
  • Fax:
Mailing address:
  • Phone: 845-699-0112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number075904
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number58-TBD
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: