Provider Demographics
NPI:1811123870
Name:THASE, ERIN LINDSEY
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:LINDSEY
Last Name:THASE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:LINDSEY
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:260 STETSON ST
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2498
Mailing Address - Country:US
Mailing Address - Phone:513-558-7700
Mailing Address - Fax:513-558-0877
Practice Address - Street 1:260 STETSON ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2498
Practice Address - Country:US
Practice Address - Phone:513-558-7700
Practice Address - Fax:513-558-0877
Is Sole Proprietor?:No
Enumeration Date:2009-06-04
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH7343103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent