MEDICARE: MRS. ERICA A HARTLAUF MSW, CSW

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	104100000X	Social Worker	4657	KY

General Provider Information

NPI Number	:	1821189515
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ERICA A HARTLAUF MSW, CSW

Provider Business Mailing Address
First Line	:	578 WOODLAND PASS
Second Line	:
City	:	MOUNT WASHINGTON
State	:	KY
Zip	:	40047-5823
Country	:	US
Telephone Number	:	502-417-2038
Fax Number	:

Provider Business Practice Location Address
First Line	:	578 WOODLAND PASS
Second Line	:
City	:	MOUNT WASHINGTON
State	:	KY
Zip	:	40047-5823
Country	:	US
Telephone Number	:	502-417-2038
Fax Number	:

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

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	04/22/2015

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