1053562157 NPI number — SHARAWN R ERWIN MSW, LMSW

Table of content: SHARAWN R ERWIN MSW, LMSW (NPI 1053562157)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053562157 NPI number — SHARAWN R ERWIN MSW, LMSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ERWIN
Provider First Name:
SHARAWN
Provider Middle Name:
R
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSW, LMSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1053562157
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/09/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
501 LAPEER
Provider Second Line Business Mailing Address:
HEALTH DELIVERY INC
Provider Business Mailing Address City Name:
SAGINAW
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48607-2810
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
989-759-6400
Provider Business Mailing Address Fax Number:
989-759-6423

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1522 JANES ST
Provider Second Line Business Practice Location Address:
JANES ST. COMMUNITY HEALTH CENTER
Provider Business Practice Location Address City Name:
SAGINAW
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48601-1819
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
989-755-0316
Provider Business Practice Location Address Fax Number:
989-755-0956
Provider Enumeration Date:
10/07/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  6801087670 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)