Provider Demographics
NPI:1083050926
Name:MORAND, ERICA (M ED)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:MORAND
Suffix:
Gender:F
Credentials:M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 W ONTARIO ST
Mailing Address - Street 2:UNIT 325
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-6942
Mailing Address - Country:US
Mailing Address - Phone:312-758-1880
Mailing Address - Fax:
Practice Address - Street 1:411 W ONTARIO ST
Practice Address - Street 2:UNIT 325
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60654-6942
Practice Address - Country:US
Practice Address - Phone:312-758-1880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-19
Last Update Date:2013-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.007210101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional