Provider Demographics
NPI:1124597455
Name:TAFT, ERIN (IADC)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:TAFT
Suffix:
Gender:F
Credentials:IADC
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:MARIE
Other - Last Name:TAFT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CADC
Mailing Address - Street 1:1706 W AGENCY RD
Mailing Address - Street 2:
Mailing Address - City:WEST BURLINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52655-1667
Mailing Address - Country:US
Mailing Address - Phone:319-753-2300
Mailing Address - Fax:
Practice Address - Street 1:400 S BROADWAY ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:IA
Practice Address - Zip Code:52601-9407
Practice Address - Country:US
Practice Address - Phone:319-768-5858
Practice Address - Fax:319-671-7030
Is Sole Proprietor?:No
Enumeration Date:2018-11-15
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA16117101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)