Provider Demographics
NPI:1285202044
Name:LOVE, ERIN MCCARTY (LAC (TEMPORARY))
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:MCCARTY
Last Name:LOVE
Suffix:
Gender:F
Credentials:LAC (TEMPORARY)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 N VENICE AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-7013
Mailing Address - Country:US
Mailing Address - Phone:541-292-0248
Mailing Address - Fax:
Practice Address - Street 1:6602 E CARONDELET DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-2119
Practice Address - Country:US
Practice Address - Phone:520-214-0818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-16
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
AZLAC-7795T101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician