Healthcare Provider Details

I. General information

NPI: 1629893656
Provider Name (Legal Business Name): ERIN L. ELLIOTT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2024
Last Update Date: 11/15/2024
Certification Date: 11/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 SYCAMORE ST.
CINCINNATI OH
45202-1305
US

IV. Provider business mailing address

909 SYCAMORE ST
CINCINNATI OH
45202-1305
US

V. Phone/Fax

Practice location:
  • Phone: 513-558-9006
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: