Provider Demographics
NPI:1679045413
Name:KEIM, ERINNE LEE (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:ERINNE
Middle Name:LEE
Last Name:KEIM
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 WATER ST
Mailing Address - Street 2:
Mailing Address - City:CUBA
Mailing Address - State:NY
Mailing Address - Zip Code:14727-1023
Mailing Address - Country:US
Mailing Address - Phone:585-968-8617
Mailing Address - Fax:585-968-8610
Practice Address - Street 1:36 WATER ST
Practice Address - Street 2:
Practice Address - City:CUBA
Practice Address - State:NY
Practice Address - Zip Code:14727-1023
Practice Address - Country:US
Practice Address - Phone:585-968-8617
Practice Address - Fax:585-968-8610
Is Sole Proprietor?:No
Enumeration Date:2018-12-18
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY083231104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker