Provider Demographics
NPI:1588925838
Name:FLANAGAN, ERIC (AAS)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:FLANAGAN
Suffix:
Gender:M
Credentials:AAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11477 OLDE CABIN RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-7130
Mailing Address - Country:US
Mailing Address - Phone:314-649-7867
Mailing Address - Fax:
Practice Address - Street 1:11477 OLDE CABIN RD
Practice Address - Street 2:SUITE 210
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-7130
Practice Address - Country:US
Practice Address - Phone:314-649-7867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-04
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)