Provider Demographics
NPI:1578969382
Name:SPRAGUE, ERIN CAITLIN (MA,CRC, LMHC)
Entity Type:Individual
Prefix:MISS
First Name:ERIN
Middle Name:CAITLIN
Last Name:SPRAGUE
Suffix:
Gender:F
Credentials:MA,CRC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5103 N NEBRASKA AVE.
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33603-2301
Mailing Address - Country:US
Mailing Address - Phone:813-238-8557
Mailing Address - Fax:813-489-2454
Practice Address - Street 1:5103 N. NEBRASKA AVE.
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603-2363
Practice Address - Country:US
Practice Address - Phone:813-238-8557
Practice Address - Fax:813-489-2454
Is Sole Proprietor?:No
Enumeration Date:2014-11-06
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH12239101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health