Provider Demographics
NPI:1366826067
Name:MANN, ERIC (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:MANN
Suffix:
Gender:M
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 N COMMERCIAL ST STE 530
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-4483
Mailing Address - Country:US
Mailing Address - Phone:206-659-9071
Mailing Address - Fax:
Practice Address - Street 1:2811 E MADISON ST STE 205C
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-4885
Practice Address - Country:US
Practice Address - Phone:206-659-9071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-13
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC605773521041C0700X
WALW608765641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical