Provider Demographics
NPI:1063843407
Name:WHITFIELD, ERICA (MACP, LMHC)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:WHITFIELD
Suffix:
Gender:F
Credentials:MACP, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 E ADAMS ST STE 320
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32202-3357
Mailing Address - Country:US
Mailing Address - Phone:904-396-4846
Mailing Address - Fax:
Practice Address - Street 1:40 E ADAMS ST STE 320
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32202-3357
Practice Address - Country:US
Practice Address - Phone:904-396-4846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-11
Last Update Date:2016-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH11373101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health