Provider Demographics
NPI:1275290744
Name:DOSSA, ERICA (MSW, LCSWA)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:DOSSA
Suffix:
Gender:F
Credentials:MSW, LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2509 WRIGHTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-5829
Mailing Address - Country:US
Mailing Address - Phone:406-579-5501
Mailing Address - Fax:
Practice Address - Street 1:9003 WESTON PKWY
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-2201
Practice Address - Country:US
Practice Address - Phone:919-677-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-19
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0170011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical