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NPI Code Detail

MEDICARE: ERIN STEWART CRIMMINS LCSW

MEDICARE: ERIN STEWART CRIMMINS 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
11041C0700XClinical Social Worker16052FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1225593759
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIN STEWART CRIMMINS LCSW
Provider Business Mailing Address
First Line : 25 SEVILLE ORANGE PATH
Second Line :
City : PALM COAST
State : FL
Zip : 32164-5403
Country : US
Telephone Number : 386-214-7369
Fax Number :
Provider Business Practice Location Address
First Line : 301 JUSTICE LN
Second Line :
City : BUNNELL
State : FL
Zip : 32110-4487
Country : US
Telephone Number : 386-254-1173
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2019
Last Update Date : 02/08/2019

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