Provider Demographics
NPI:1861622342
Name:BRYANT, ERIN V (LISW)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:V
Last Name:BRYANT
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:647 HILL RD N
Mailing Address - Street 2:SUITE B
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-9168
Mailing Address - Country:US
Mailing Address - Phone:614-833-6900
Mailing Address - Fax:614-833-6903
Practice Address - Street 1:647 HILL RD N
Practice Address - Street 2:SUITE B
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-9168
Practice Address - Country:US
Practice Address - Phone:614-833-6900
Practice Address - Fax:614-833-6903
Is Sole Proprietor?:No
Enumeration Date:2009-07-20
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI1100191104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH021931Medicare PIN