Provider Demographics
NPI:1467099960
Name:SMITH, ERIKA L (RAC)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:L
Last Name:SMITH
Suffix:
Gender:F
Credentials:RAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1342 MAGNOLIA RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-1490
Mailing Address - Country:US
Mailing Address - Phone:225-505-4239
Mailing Address - Fax:
Practice Address - Street 1:3535 BRENTWOOD DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-1643
Practice Address - Country:US
Practice Address - Phone:225-757-8044
Practice Address - Fax:225-250-5554
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-03
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1597101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty