Healthcare Provider Details

I. General information

NPI: 1518504919
Provider Name (Legal Business Name): ERICA ATKINS MCGUIRE QMHS CMS CPST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2019
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36466 STATE ROUTE 30
LISBON OH
44432-9417
US

IV. Provider business mailing address

241 MAPLE ST
LISBON OH
44432-1223
US

V. Phone/Fax

Practice location:
  • Phone: 234-736-8425
  • Fax:
Mailing address:
  • Phone: 330-870-4127
  • Fax: 330-870-4139

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: