Provider Demographics
NPI:1083497291
Name:ERICA WOODALL COUNSELING, PLLC
Entity Type:Organization
Organization Name:ERICA WOODALL COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODALL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:940-594-6545
Mailing Address - Street 1:3020 BROADMOOR LN STE 200
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75022-2705
Mailing Address - Country:US
Mailing Address - Phone:940-331-0505
Mailing Address - Fax:
Practice Address - Street 1:3020 BROADMOOR LN STE 200
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75022-2705
Practice Address - Country:US
Practice Address - Phone:940-331-0505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)