Provider Demographics
NPI:1982425096
Name:HOLTZBERG, ERIN (MSW)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:HOLTZBERG
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 COTTAGE GROVE RD STE C210
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-4207
Mailing Address - Country:US
Mailing Address - Phone:860-233-9772
Mailing Address - Fax:
Practice Address - Street 1:701 COTTAGE GROVE RD STE C210
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-4207
Practice Address - Country:US
Practice Address - Phone:860-233-9772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT10031104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker