Provider Demographics
NPI:1013419837
Name:WALTERS, ERICKA M (LGSW)
Entity Type:Individual
Prefix:
First Name:ERICKA
Middle Name:M
Last Name:WALTERS
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:ERICKA
Other - Middle Name:M
Other - Last Name:PETERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:693 ARBOR DR
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21158-1450
Mailing Address - Country:US
Mailing Address - Phone:267-231-7426
Mailing Address - Fax:
Practice Address - Street 1:77-81 E. MAIN STREET
Practice Address - Street 2:SUITE 406
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157
Practice Address - Country:US
Practice Address - Phone:410-861-0073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-07
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD216541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical