=====================================================
General NPI Number Information
=====================================================
NPI Number | 1265011977
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ERIN A WHEELER LISW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/08/2021
-----------------------------------------------------
Last Update Date | 09/17/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 303 3RD AVE
-----------------------------------------------------
City | CHESAPEAKE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45619-1144
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 740-451-0415
-----------------------------------------------------
Fax | 800-480-7578
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 273 TOWNSHIP ROAD 1273
-----------------------------------------------------
City | CHESAPEAKE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45619-8564
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 740-876-1888
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | I.2405120
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------