Provider Demographics
NPI:1003065061
Name:WOODRUFF, ERICA M (PLMHP)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:M
Last Name:WOODRUFF
Suffix:
Gender:F
Credentials:PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 LAKE ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68502-3734
Mailing Address - Country:US
Mailing Address - Phone:402-481-5496
Mailing Address - Fax:402-481-5495
Practice Address - Street 1:1650 LAKE ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68502-3734
Practice Address - Country:US
Practice Address - Phone:402-481-5496
Practice Address - Fax:402-481-5495
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-15
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8712101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health