MEDICARE: ERIN DRUM LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	12267034-3501	UT

General Provider Information

NPI Number	:	1194405613
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN DRUM LCSW

Provider Business Mailing Address
First Line	:	255 N VIRGINIA ST
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84103-4333
Country	:	US
Telephone Number	:	208-921-4431
Fax Number	:

Provider Business Practice Location Address
First Line	:	255 N VIRGINIA ST
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84103-4333
Country	:	US
Telephone Number	:	208-921-4431
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2023
Last Update Date	:	07/19/2023

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Directions to “ ERIN DRUM LCSW” Practice Location

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