Healthcare Provider Details

I. General information

NPI: 1275885345
Provider Name (Legal Business Name): ERIN MARIE GUMM LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2012
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

S4395 COUNTY RD. NL
AUGUSTA WI
54722
US

IV. Provider business mailing address

S4395 COUNTY ROAD NL
AUGUSTA WI
54722-5024
US

V. Phone/Fax

Practice location:
  • Phone: 641-691-1159
  • Fax:
Mailing address:
  • Phone: 641-691-1159
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number001678
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: