MEDICARE: MITZI EHRLICH

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	15825	LA

General Provider Information

NPI Number	:	1780554204
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MITZI EHRLICH

Provider Business Mailing Address
First Line	:	PO BOX 66558
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70896-6558
Country	:	US
Telephone Number	:	225-922-2700
Fax Number	:	225-362-5319

Provider Business Practice Location Address
First Line	:	1056 E WORTHY ST STE B
Second Line	:
City	:	GONZALES
State	:	LA
Zip	:	70737-4369
Country	:	US
Telephone Number	:	225-621-5770
Fax Number	:	833-606-6429

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

Provider Enumeration Date	:	11/10/2025
Last Update Date	:	02/05/2026

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Directions to “ MITZI EHRLICH ” Practice Location

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