Provider Demographics
NPI:1225868052
Name:DRAKE, ERIN E (TLMHC)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:E
Last Name:DRAKE
Suffix:
Gender:F
Credentials:TLMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 MCKENZIE AVE
Mailing Address - Street 2:
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51503-1011
Mailing Address - Country:US
Mailing Address - Phone:712-986-7800
Mailing Address - Fax:
Practice Address - Street 1:303 MCKENZIE AVE
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503-1011
Practice Address - Country:US
Practice Address - Phone:712-786-7800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA127083101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health