Provider Demographics
NPI:1073099719
Name:BLESSING, ERICA MARIE I (LSW)
Entity Type:Individual
Prefix:MS
First Name:ERICA
Middle Name:MARIE
Last Name:BLESSING
Suffix:I
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 IRONWOOD PL
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-2670
Mailing Address - Country:US
Mailing Address - Phone:208-640-4422
Mailing Address - Fax:
Practice Address - Street 1:2201 IRONWOOD PL
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2670
Practice Address - Country:US
Practice Address - Phone:208-640-4422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-16
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLSW-37124104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker