Provider Demographics
NPI:1508372301
Name:SLEDGE, ERIKA MALAISHA (LPC)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:MALAISHA
Last Name:SLEDGE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 DOGWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:PORT WENTWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:31407-3333
Mailing Address - Country:US
Mailing Address - Phone:912-223-6032
Mailing Address - Fax:
Practice Address - Street 1:14 DOGWOOD CIR
Practice Address - Street 2:
Practice Address - City:PORT WENTWORTH
Practice Address - State:GA
Practice Address - Zip Code:31407-3333
Practice Address - Country:US
Practice Address - Phone:912-223-6032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-17
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC009963101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional