Basic Information
Provider Information
NPI: 1881882546
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MORROW
FirstName: ERICA
MiddleName: N
NamePrefix:  
NameSuffix:  
Credential: LISW-S
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 474 N YELLOW SPRINGS ST
Address2:  
City: SPRINGFIELD
State: OH
PostalCode: 455042463
CountryCode: US
TelephoneNumber: 9373999500
FaxNumber: 9373424242
Practice Location
Address1: 474 N YELLOW SPRINGS ST
Address2:  
City: SPRINGFIELD
State: OH
PostalCode: 45504
CountryCode: US
TelephoneNumber: 9373999500
FaxNumber: 9373424242
Other Information
ProviderEnumerationDate: 10/09/2007
LastUpdateDate: 06/04/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700XI.1500242-SUPVOHY Behavioral Health & Social Service ProvidersSocial WorkerClinical
104100000XS0600280OHN Behavioral Health & Social Service ProvidersSocial Worker 

No ID Information.


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