Provider Demographics
NPI:1053889402
Name:STROTHER, ERIC (LCSW)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:STROTHER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N3152 STATE ROAD 81
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WI
Mailing Address - Zip Code:53566-8821
Mailing Address - Country:US
Mailing Address - Phone:608-328-9393
Mailing Address - Fax:608-328-9480
Practice Address - Street 1:N3152 STATE ROAD 81
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WI
Practice Address - Zip Code:53566-8821
Practice Address - Country:US
Practice Address - Phone:608-328-9393
Practice Address - Fax:608-328-9480
Is Sole Proprietor?:No
Enumeration Date:2018-11-04
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099271531041C0700X
171M00000X
WI9814-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator