Provider Demographics
NPI:1487309027
Name:MRAKOVICH, ERIN (LCSW)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:MRAKOVICH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9831 CHESTERTON DR
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46280-1845
Mailing Address - Country:US
Mailing Address - Phone:317-296-3953
Mailing Address - Fax:
Practice Address - Street 1:9650 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-7636
Practice Address - Country:US
Practice Address - Phone:317-296-8953
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-11
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34008833A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical