Provider Demographics
NPI:1144561143
Name:CARR, ERIN LYNN
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:LYNN
Last Name:CARR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16647 WYOMING ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48221-2848
Mailing Address - Country:US
Mailing Address - Phone:313-342-3606
Mailing Address - Fax:313-861-0413
Practice Address - Street 1:16647 WYOMING ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48221-2848
Practice Address - Country:US
Practice Address - Phone:313-342-3606
Practice Address - Fax:313-861-0413
Is Sole Proprietor?:No
Enumeration Date:2013-03-15
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011154561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical