| Benita W Erwin Lcsw Inc Pc | |
|
2100 N Broadway Ave Ada OK 74820-1048 | |
| (580) 436-7120 | |
| Not Available |
| Full Name | Benita W Erwin Lcsw Inc Pc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 2100 N Broadway Ave, Ada, Oklahoma |
| Authorized Official Name and Position | Benita Erwin (PRESIDENT) |
| Authorized Official Contact | 5804367120 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Benita W Erwin Lcsw Inc Pc 14537 County Road 3510 Ada OK 74820-2711 Ph: (580) 436-7120 | Benita W Erwin Lcsw Inc Pc 2100 N Broadway Ave Ada OK 74820-1048 Ph: (580) 436-7120 |
| NPI Number | 1073627659 |
|---|---|
| Provider Enumeration Date | 08/19/2006 |
| Last Update Date | 08/20/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073627659 | NPI | - | NPPES |
| 441743622003 | Other | OK | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 2252 (Oklahoma) | Primary |
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