Provider Demographics
NPI:1922378827
Name:STRETAR, ERIN (LISW)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:STRETAR
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:389 ORCHARD AVE NE
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-2555
Mailing Address - Country:US
Mailing Address - Phone:330-754-8882
Mailing Address - Fax:
Practice Address - Street 1:230 S COURT ST STE 5
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-2259
Practice Address - Country:US
Practice Address - Phone:330-723-7977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-09
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI1101204104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker