Provider Demographics
NPI:1205538147
Name:LAS, ERIN KATHRYN (LCSW)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:KATHRYN
Last Name:LAS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16326 S ELLNA CT
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60586-9011
Mailing Address - Country:US
Mailing Address - Phone:630-740-2881
Mailing Address - Fax:
Practice Address - Street 1:800 W 5TH AVE STE 205I
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-3454
Practice Address - Country:US
Practice Address - Phone:630-779-0751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-21
Last Update Date:2024-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.101806104100000X
IL149.0269241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker