Provider Demographics
NPI:1275713679
Name:ESTRELLA, ERIN HUNT (LICSW)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:HUNT
Last Name:ESTRELLA
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1713
Mailing Address - Street 2:
Mailing Address - City:WEST TISBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02575-1713
Mailing Address - Country:US
Mailing Address - Phone:401-440-1277
Mailing Address - Fax:401-223-6301
Practice Address - Street 1:394 ANGELL ST FL 1
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-4005
Practice Address - Country:US
Practice Address - Phone:401-440-1277
Practice Address - Fax:401-223-6301
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-14
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICSW011171041C0700X
MA2148201041C0700X
RIISW020751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical