Provider Demographics
NPI:1972945533
Name:AVEN, ERIN (PHD)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:AVEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:
Other - Last Name:ARMOUTLIEV
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:340 S BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44308-1529
Mailing Address - Country:US
Mailing Address - Phone:330-253-3100
Mailing Address - Fax:330-253-5248
Practice Address - Street 1:340 S BROADWAY ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44308-1529
Practice Address - Country:US
Practice Address - Phone:330-253-3100
Practice Address - Fax:330-253-5248
Is Sole Proprietor?:No
Enumeration Date:2013-07-24
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH7187103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2314561Medicaid
OHH358420Medicare PIN