Provider Demographics
NPI:1376898999
Name:DOLAN, ERIN ROSE (MS, ATR, LPC)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:ROSE
Last Name:DOLAN
Suffix:
Gender:F
Credentials:MS, ATR, LPC
Other - Prefix:MISS
Other - First Name:ERIN
Other - Middle Name:ROSE
Other - Last Name:PETERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2223 TAFT ST NE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55418-4129
Mailing Address - Country:US
Mailing Address - Phone:651-645-5323
Mailing Address - Fax:651-328-8254
Practice Address - Street 1:1449 CLEVELAND AVE N
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55108-1413
Practice Address - Country:US
Practice Address - Phone:651-645-5323
Practice Address - Fax:651-328-8254
Is Sole Proprietor?:No
Enumeration Date:2012-07-19
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN01222101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health