Provider Demographics
NPI:1073987327
Name:WARREN, ERICKA (LLMSW)
Entity Type:Individual
Prefix:
First Name:ERICKA
Middle Name:
Last Name:WARREN
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18966 GREENFIELD RD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235-2907
Mailing Address - Country:US
Mailing Address - Phone:313-397-1611
Mailing Address - Fax:313-397-1340
Practice Address - Street 1:18966 GREENFIELD RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235-2907
Practice Address - Country:US
Practice Address - Phone:313-397-1611
Practice Address - Fax:313-397-1340
Is Sole Proprietor?:No
Enumeration Date:2015-11-24
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801094964104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker