Provider Demographics
NPI:1083033534
Name:ERIKA WOOLF PSYD LLC
Entity Type:Organization
Organization Name:ERIKA WOOLF PSYD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:L
Authorized Official - Last Name:WOOLF
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:352-689-7238
Mailing Address - Street 1:PO BOX 121735
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34712-1735
Mailing Address - Country:US
Mailing Address - Phone:352-689-7238
Mailing Address - Fax:
Practice Address - Street 1:513 CADIZ DR
Practice Address - Street 2:
Practice Address - City:GROVELAND
Practice Address - State:FL
Practice Address - Zip Code:34736-8017
Practice Address - Country:US
Practice Address - Phone:352-689-7238
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-14
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY82323104A0625X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness