Provider Demographics
NPI:1558478388
Name:HUNTER, ERIN L (LCSW)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:L
Last Name:HUNTER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:L
Other - Last Name:WAGONER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:50 MOODY ST
Mailing Address - Street 2:
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-1536
Mailing Address - Country:US
Mailing Address - Phone:800-434-3000
Mailing Address - Fax:
Practice Address - Street 1:50 MOODY ST
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-1536
Practice Address - Country:US
Practice Address - Phone:800-434-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO118104100000X
MELC169811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO118OtherLSW