Provider Demographics
NPI:1093352155
Name:ERIN PAUL ASSOCIATES, LLC
Entity Type:Organization
Organization Name:ERIN PAUL ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:P
Authorized Official - Last Name:PAUL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:630-546-3800
Mailing Address - Street 1:520 APACHE TRL
Mailing Address - Street 2:
Mailing Address - City:LAKE VILLA
Mailing Address - State:IL
Mailing Address - Zip Code:60046-9100
Mailing Address - Country:US
Mailing Address - Phone:630-546-3800
Mailing Address - Fax:
Practice Address - Street 1:884 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:IL
Practice Address - Zip Code:60002-1226
Practice Address - Country:US
Practice Address - Phone:630-546-3800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-06
Last Update Date:2019-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)