Provider Demographics
NPI:1063852622
Name:LOGAN, ERIN M (MS LPC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:M
Last Name:LOGAN
Suffix:
Gender:F
Credentials:MS LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7908 NW 23RD STREET
Mailing Address - Street 2:
Mailing Address - City:BETHANY
Mailing Address - State:OK
Mailing Address - Zip Code:73008-4950
Mailing Address - Country:US
Mailing Address - Phone:779-537-2164
Mailing Address - Fax:
Practice Address - Street 1:529 N GRAND ST
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-3216
Practice Address - Country:US
Practice Address - Phone:580-234-8880
Practice Address - Fax:580-234-8891
Is Sole Proprietor?:No
Enumeration Date:2013-06-27
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health