Provider Demographics
NPI:1215538160
Name:HAUSKNECHT, ERIN CHRISTINE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:CHRISTINE
Last Name:HAUSKNECHT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:ERIN
Other - Middle Name:CHRISTINE
Other - Last Name:COOLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1082
Mailing Address - Street 2:
Mailing Address - City:FRENCHTOWN
Mailing Address - State:MT
Mailing Address - Zip Code:59834-1082
Mailing Address - Country:US
Mailing Address - Phone:406-239-3290
Mailing Address - Fax:
Practice Address - Street 1:7168 EXPRESSWAY
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59808-8587
Practice Address - Country:US
Practice Address - Phone:406-239-3290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-06
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT430991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical