Healthcare Provider Details

I. General information

NPI: 1114687332
Provider Name (Legal Business Name): ERIN ELIZABETH VANDERSTEEN LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2021
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 CROSS ST
WARWICK RI
02888-1226
US

IV. Provider business mailing address

4 CROSS ST
WARWICK RI
02888-1226
US

V. Phone/Fax

Practice location:
  • Phone: 857-245-6318
  • Fax: 339-219-1002
Mailing address:
  • Phone: 857-245-6318
  • Fax: 339-219-1002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberISW04565
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: