Provider Demographics
NPI:1790254936
Name:SCOVELL, ERIN MONICA (BS, LADC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:MONICA
Last Name:SCOVELL
Suffix:
Gender:F
Credentials:BS, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 SOUTH CT
Mailing Address - Street 2:
Mailing Address - City:EVELETH
Mailing Address - State:MN
Mailing Address - Zip Code:55734-1436
Mailing Address - Country:US
Mailing Address - Phone:218-410-0720
Mailing Address - Fax:
Practice Address - Street 1:300 S 5TH AVE
Practice Address - Street 2:
Practice Address - City:VIRGINIA
Practice Address - State:MN
Practice Address - Zip Code:55792-2665
Practice Address - Country:US
Practice Address - Phone:218-749-7106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-16
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)