Provider Demographics
NPI:1508530668
Name:ALBERTIE-YOUNG, ERIKA CHARRELL (LCSW)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:CHARRELL
Last Name:ALBERTIE-YOUNG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ERIKA
Other - Middle Name:CHARRELL
Other - Last Name:ALBERTIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:989 S US HIGHWAY 27
Mailing Address - Street 2:
Mailing Address - City:LADY LAKE
Mailing Address - State:FL
Mailing Address - Zip Code:32159-5239
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:989 S US HIGHWAY 27
Practice Address - Street 2:
Practice Address - City:LADY LAKE
Practice Address - State:FL
Practice Address - Zip Code:32159-5239
Practice Address - Country:US
Practice Address - Phone:904-415-9090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-03
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
FL165101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health