Provider Demographics
NPI:1477067569
Name:BRANDON, ERICA DENISE (LCSWA)
Entity Type:Individual
Prefix:MS
First Name:ERICA
Middle Name:DENISE
Last Name:BRANDON
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:MS
Other - First Name:ERICA
Other - Middle Name:DENISE
Other - Last Name:BRANDON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSWA
Mailing Address - Street 1:7 MEADOWCREST DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-2571
Mailing Address - Country:US
Mailing Address - Phone:919-408-6274
Mailing Address - Fax:
Practice Address - Street 1:309 CRUTCHFIELD ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-2754
Practice Address - Country:US
Practice Address - Phone:919-560-7305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-28
Last Update Date:2017-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0117111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical