Provider Demographics
NPI:1275885345
Name:GUMM, ERIN MARIE (LMHC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:MARIE
Last Name:GUMM
Suffix:
Gender:F
Credentials:LMHC
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 366
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:IA
Mailing Address - Zip Code:52342-0366
Mailing Address - Country:US
Mailing Address - Phone:641-691-1159
Mailing Address - Fax:
Practice Address - Street 1:105 W OHIO ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:IA
Practice Address - Zip Code:52342-1323
Practice Address - Country:US
Practice Address - Phone:641-691-1159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-12
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001678101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health