Healthcare Provider Details

I. General information

NPI: 1265874085
Provider Name (Legal Business Name): ERIN A. HARRIS LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERIN A POWERS LISW

II. Dates (important events)

Enumeration Date: 07/22/2013
Last Update Date: 10/13/2021
Certification Date: 10/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1581 DODD DR
COLUMBUS OH
43210-1257
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-366-3276
  • Fax: 614-366-6373
Mailing address:
  • Phone: 614-366-3276
  • Fax: 614-366-4709

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS1302566
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.1501333
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: