MEDICARE: MICHAEL ERWIN

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	2025-000346	NJ
2	101YM0800X	Mental Health Counselor	37AC00963200	NJ

General Provider Information

NPI Number	:	1811822349
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL ERWIN

Provider Business Mailing Address
First Line	:	77 JEFFERSON AVE
Second Line	:
City	:	MAPLEWOOD
State	:	NJ
Zip	:	07040-1228
Country	:	US
Telephone Number	:	678-232-2232
Fax Number	:

Provider Business Practice Location Address
First Line	:	77 JEFFERSON AVE
Second Line	:
City	:	MAPLEWOOD
State	:	NJ
Zip	:	07040-1228
Country	:	US
Telephone Number	:	678-232-2232
Fax Number	:

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

Provider Enumeration Date	:	06/16/2026
Last Update Date	:	06/16/2026

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