1215538160 NPI number — MRS. ERIN CHRISTINE HAUSKNECHT LCSW

Table of content: MRS. ERIN CHRISTINE HAUSKNECHT LCSW (NPI 1215538160)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215538160 NPI number — MRS. ERIN CHRISTINE HAUSKNECHT LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAUSKNECHT
Provider First Name:
ERIN
Provider Middle Name:
CHRISTINE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
COOLEY
Provider Other First Name:
ERIN
Provider Other Middle Name:
CHRISTINE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1215538160
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/08/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1082
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FRENCHTOWN
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59834-1082
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-239-3290
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7168 EXPRESSWAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MISSOULA
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59808-8587
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-239-3290
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/06/2020

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:  43099 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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