MEDICARE: ERICA ATKINS MCGUIRE QMHS CMS CPST

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	171M00000X	Case Manager/Care Coordinator
2	174400000X	Specialist

General Provider Information

NPI Number	:	1518504919
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERICA ATKINS MCGUIRE QMHS CMS CPST

Provider Business Mailing Address
First Line	:	241 MAPLE ST
Second Line	:
City	:	LISBON
State	:	OH
Zip	:	44432-1223
Country	:	US
Telephone Number	:	330-870-4127
Fax Number	:	330-870-4139

Provider Business Practice Location Address
First Line	:	36466 STATE ROUTE 30
Second Line	:
City	:	LISBON
State	:	OH
Zip	:	44432-9417
Country	:	US
Telephone Number	:	234-736-8425
Fax Number	:

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

Provider Enumeration Date	:	12/04/2019
Last Update Date	:	06/05/2026

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