Provider Demographics
NPI:1205166832
Name:DEEHAN, ERIN KATE (LICSW)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:KATE
Last Name:DEEHAN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MS
Other - First Name:ERIN
Other - Middle Name:KATE
Other - Last Name:MOYNIHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:38 GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:EAST WALPOLE
Mailing Address - State:MA
Mailing Address - Zip Code:02032-1412
Mailing Address - Country:US
Mailing Address - Phone:508-850-9044
Mailing Address - Fax:
Practice Address - Street 1:38 GRANT AVE
Practice Address - Street 2:
Practice Address - City:EAST WALPOLE
Practice Address - State:MA
Practice Address - Zip Code:02032-1412
Practice Address - Country:US
Practice Address - Phone:508-850-9044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-04
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1112101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical