Provider Demographics
NPI:1275638538
Name:ERNENWEIN, FRANK C (LMSW, CASAC)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:C
Last Name:ERNENWEIN
Suffix:
Gender:M
Credentials:LMSW, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1031 E FAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210
Mailing Address - Country:US
Mailing Address - Phone:315-425-4400
Mailing Address - Fax:315-425-4406
Practice Address - Street 1:1031 E FAYETTE ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210
Practice Address - Country:US
Practice Address - Phone:315-425-4400
Practice Address - Fax:315-425-4406
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYCASAC 5387101YA0400X
NYCASAC 5387/LMSW104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker