Provider Demographics
NPI:1407372097
Name:GOBEL, ERICA R (LGSW)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:R
Last Name:GOBEL
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 N PIKE STREET
Mailing Address - Street 2:P.O. 399
Mailing Address - City:GRAFTON
Mailing Address - State:WV
Mailing Address - Zip Code:26354-1270
Mailing Address - Country:US
Mailing Address - Phone:304-265-0312
Mailing Address - Fax:304-265-0314
Practice Address - Street 1:725 N PIKE ST
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:WV
Practice Address - Zip Code:26354-1270
Practice Address - Country:US
Practice Address - Phone:304-265-4909
Practice Address - Fax:304-265-4915
Is Sole Proprietor?:No
Enumeration Date:2017-08-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVBP00943905104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker