Provider Demographics
NPI:1912493214
Name:VAN OSS, ERIN M (PHD, NCSP)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:M
Last Name:VAN OSS
Suffix:
Gender:F
Credentials:PHD, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N6915 RIVER DR
Mailing Address - Street 2:
Mailing Address - City:SHAWANO
Mailing Address - State:WI
Mailing Address - Zip Code:54166-4222
Mailing Address - Country:US
Mailing Address - Phone:715-600-3275
Mailing Address - Fax:
Practice Address - Street 1:N6915 RIVER DR
Practice Address - Street 2:
Practice Address - City:SHAWANO
Practice Address - State:WI
Practice Address - Zip Code:54166-4222
Practice Address - Country:US
Practice Address - Phone:715-600-3275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-10
Last Update Date:2023-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI912-58103TS0200X
WI5080-57103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool