Provider Demographics
NPI:1750619904
Name:CARROLL, ERIN ELIZABETH (LISW-S)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:ELIZABETH
Last Name:CARROLL
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14900 COUNTY ROAD H
Mailing Address - Street 2:#57
Mailing Address - City:WAUSEON
Mailing Address - State:OH
Mailing Address - Zip Code:43567-8824
Mailing Address - Country:US
Mailing Address - Phone:419-822-1670
Mailing Address - Fax:
Practice Address - Street 1:830 N SUMMIT ST
Practice Address - Street 2:SUITE 2
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43604-1884
Practice Address - Country:US
Practice Address - Phone:419-693-9600
Practice Address - Fax:419-693-9650
Is Sole Proprietor?:No
Enumeration Date:2009-11-30
Last Update Date:2015-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.11012571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical