Provider Demographics
NPI:1144620139
Name:WASHINGTON, ERICA (MA, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14741 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:IL
Mailing Address - Zip Code:60426-1922
Mailing Address - Country:US
Mailing Address - Phone:773-649-9479
Mailing Address - Fax:
Practice Address - Street 1:14741 MAIN ST
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:IL
Practice Address - Zip Code:60426-1922
Practice Address - Country:US
Practice Address - Phone:708-462-2134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-27
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39004205A101YM0800X
IL178.012205101YM0800X
IL180013175101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health