Provider Demographics
NPI:1811202260
Name:THUNER, ERIN LEIANN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:LEIANN
Last Name:THUNER
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 1:1425 21ST AVE NW STE C
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58703-0817
Mailing Address - Country:US
Mailing Address - Phone:701-858-0888
Mailing Address - Fax:
Practice Address - Street 1:1425 21ST AVE NW STE C
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58703-0817
Practice Address - Country:US
Practice Address - Phone:701-858-0888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-10
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND37521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1477592533OtherNORTH CENTRAL HUMAN SERVICE CENTER
ND54517Medicaid