Provider Demographics
NPI:1174006639
Name:HAGEN, ERIN R (LPCC)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:R
Last Name:HAGEN
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3239 OAK RIDGE LOOP E
Mailing Address - Street 2:
Mailing Address - City:WEST FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58078-8482
Mailing Address - Country:US
Mailing Address - Phone:701-478-7199
Mailing Address - Fax:701-478-1763
Practice Address - Street 1:3239 OAK RIDGE LOOP E
Practice Address - Street 2:
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078-8482
Practice Address - Country:US
Practice Address - Phone:701-478-7199
Practice Address - Fax:701-478-1763
Is Sole Proprietor?:No
Enumeration Date:2018-09-11
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND6461110929101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional