Provider Demographics
NPI:1073772091
Name:CRETENS, ERIN LEE (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:LEE
Last Name:CRETENS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4003 D RD
Mailing Address - Street 2:
Mailing Address - City:BARK RIVER
Mailing Address - State:MI
Mailing Address - Zip Code:49807-9612
Mailing Address - Country:US
Mailing Address - Phone:906-275-4062
Mailing Address - Fax:
Practice Address - Street 1:N 15019 HANNAHVILE B1 ROAD
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:MI
Practice Address - Zip Code:49896
Practice Address - Country:US
Practice Address - Phone:906-275-4062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801090209101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health