Provider Demographics
NPI:1306223953
Name:GATES, ERIN FUTROVSKY (LGSW)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:FUTROVSKY
Last Name:GATES
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:
Other - Last Name:FUTROVSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LGSW
Mailing Address - Street 1:11140 ROCKVILLE PIKE
Mailing Address - Street 2:442
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852
Mailing Address - Country:US
Mailing Address - Phone:301-922-4382
Mailing Address - Fax:301-840-1348
Practice Address - Street 1:11140 ROCKVILLE PIKE
Practice Address - Street 2:442
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852
Practice Address - Country:US
Practice Address - Phone:301-922-4382
Practice Address - Fax:301-840-1348
Is Sole Proprietor?:No
Enumeration Date:2015-05-04
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20297104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker