Provider Demographics
NPI:1407089550
Name:LAFFREY, ERIN R (LISW-S)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:R
Last Name:LAFFREY
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4385 MOSELLE DR
Mailing Address - Street 2:
Mailing Address - City:LIBERTY TWP
Mailing Address - State:OH
Mailing Address - Zip Code:45011-5288
Mailing Address - Country:US
Mailing Address - Phone:304-904-7722
Mailing Address - Fax:
Practice Address - Street 1:3333 BURNET AVE
Practice Address - Street 2:MAIL LOCATION 6019
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3026
Practice Address - Country:US
Practice Address - Phone:513-636-4124
Practice Address - Fax:513-636-4283
Is Sole Proprietor?:No
Enumeration Date:2009-08-24
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
OHI.0009378-SUPV1041C0700X
OHI0009378101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1407089550Medicaid
OHMC0713Medicaid
OH000000633336OtherANTHEM BC/BS