Healthcare Provider Details

I. General information

NPI: 1982241071
Provider Name (Legal Business Name): KATIE ELIZABETH WOOD LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2019
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 CRANBERRY ST STE 220
ERIE PA
16507-1090
US

IV. Provider business mailing address

410 CRANBERRY ST STE 220
ERIE PA
16507-1090
US

V. Phone/Fax

Practice location:
  • Phone: 814-315-0047
  • Fax:
Mailing address:
  • Phone: 814-315-0047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW136804
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW022311
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: