Provider Demographics
NPI:1265874085
Name:HARRIS, ERIN A (LISW)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:A
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:A
Other - Last Name:POWERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-366-3276
Mailing Address - Fax:614-366-4709
Practice Address - Street 1:1581 DODD DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1257
Practice Address - Country:US
Practice Address - Phone:614-366-3276
Practice Address - Fax:614-366-6373
Is Sole Proprietor?:No
Enumeration Date:2013-07-22
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS1302566104100000X
OHI.15013331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0217840Medicaid