Provider Demographics
NPI:1407381841
Name:ERIN L CAVANAUGH LCMFT, LLC
Entity Type:Organization
Organization Name:ERIN L CAVANAUGH LCMFT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:CAVANAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:LCMFT
Authorized Official - Phone:316-263-3627
Mailing Address - Street 1:439 N MCLEAN BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67203-5914
Mailing Address - Country:US
Mailing Address - Phone:316-263-3627
Mailing Address - Fax:877-548-5314
Practice Address - Street 1:439 N MCLEAN BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-5914
Practice Address - Country:US
Practice Address - Phone:316-263-3627
Practice Address - Fax:877-548-5314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-24
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS846106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty