Provider Demographics
NPI:1538392790
Name:AUSTIN, ERIN RENEE CLOSE (LCSW)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:RENEE CLOSE
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:RENEE
Other - Last Name:CLOSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2414
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23058-2414
Mailing Address - Country:US
Mailing Address - Phone:804-512-1915
Mailing Address - Fax:
Practice Address - Street 1:107 S 5TH ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23219-3825
Practice Address - Country:US
Practice Address - Phone:804-819-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-03
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040072001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA4945255Medicaid
VACO4867Medicare PIN