Provider Demographics
NPI:1598358756
Name:MANKIN, ERIN JANE (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:JANE
Last Name:MANKIN
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15271 MCGREGOR BLVD
Mailing Address - Street 2:STE 16, #271
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908
Mailing Address - Country:US
Mailing Address - Phone:239-789-5912
Mailing Address - Fax:
Practice Address - Street 1:15271 MCGREGOR BLVD
Practice Address - Street 2:STE 16, #271
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908
Practice Address - Country:US
Practice Address - Phone:813-400-3605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-18
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH18510101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health