Provider Demographics
NPI:1942348339
Name:GOMES, ERIN LEE (MSW, LICSW)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:LEE
Last Name:GOMES
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 TABER ST
Mailing Address - Street 2:
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-3311
Mailing Address - Country:US
Mailing Address - Phone:508-997-3734
Mailing Address - Fax:
Practice Address - Street 1:99 SUMMER ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02110-1213
Practice Address - Country:US
Practice Address - Phone:617-587-1500
Practice Address - Fax:617-587-1577
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1110341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical