Provider Demographics
NPI:1356808539
Name:CRAVENS, ERIN M (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:M
Last Name:CRAVENS
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 S 20TH AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-6837
Mailing Address - Country:US
Mailing Address - Phone:406-579-4312
Mailing Address - Fax:
Practice Address - Street 1:716 S 20TH AVE STE 201
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-6837
Practice Address - Country:US
Practice Address - Phone:406-579-4312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-25
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCSW-LIC-359721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical