Provider Demographics
NPI:1124308556
Name:SMALL, ERIN LEIGH (MA, CASAC-T)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:LEIGH
Last Name:SMALL
Suffix:
Gender:F
Credentials:MA, CASAC-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-5408
Mailing Address - Country:US
Mailing Address - Phone:845-562-8255
Mailing Address - Fax:
Practice Address - Street 1:280 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-5408
Practice Address - Country:US
Practice Address - Phone:845-562-8255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-17
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00164900101YA0400X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)