Provider Demographics
NPI:1356520589
Name:GILLIGAN, ERIN E (LICSW)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:E
Last Name:GILLIGAN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 26
Mailing Address - Street 2:
Mailing Address - City:NEW BOSTON
Mailing Address - State:NH
Mailing Address - Zip Code:03070
Mailing Address - Country:US
Mailing Address - Phone:603-497-7866
Mailing Address - Fax:
Practice Address - Street 1:192 JOE ENGLISH RD.
Practice Address - Street 2:
Practice Address - City:NEW BOSTON
Practice Address - State:NH
Practice Address - Zip Code:03070-0382
Practice Address - Country:US
Practice Address - Phone:603-497-7866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-24
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3080905Medicaid
NHPTAN RE 2534Medicare PIN