Provider Demographics
NPI:1083742290
Name:NEIL, ERIKA LANE
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:LANE
Last Name:NEIL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ERIKA
Other - Middle Name:LANE
Other - Last Name:NEIL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW, JD
Mailing Address - Street 1:15284 SURREY HOUSE WAY
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20120-1178
Mailing Address - Country:US
Mailing Address - Phone:703-449-0276
Mailing Address - Fax:
Practice Address - Street 1:5675 STONE RD
Practice Address - Street 2:SUITE 300
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20120-1667
Practice Address - Country:US
Practice Address - Phone:703-864-2807
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VACLSW09040061531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical