Provider Demographics
NPI:1376207092
Name:LARKINS, ERICK L
Entity Type:Individual
Prefix:
First Name:ERICK
Middle Name:L
Last Name:LARKINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21491 WESTPORT AVE
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44123-2855
Mailing Address - Country:US
Mailing Address - Phone:234-901-9883
Mailing Address - Fax:
Practice Address - Street 1:1507 SAINT CLAIR AVE NE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44114-2003
Practice Address - Country:US
Practice Address - Phone:234-901-9883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-28
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator