Provider Demographics
NPI:1538695515
Name:HAUGH, ERICA (LADC)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:HAUGH
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:
Other - Last Name:SCHAVEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:408 W FOUNTAIN ST
Mailing Address - Street 2:
Mailing Address - City:ALBERT LEA
Mailing Address - State:MN
Mailing Address - Zip Code:56007-2437
Mailing Address - Country:US
Mailing Address - Phone:507-377-6411
Mailing Address - Fax:507-377-6443
Practice Address - Street 1:408 W FOUNTAIN ST
Practice Address - Street 2:
Practice Address - City:ALBERT LEA
Practice Address - State:MN
Practice Address - Zip Code:56007-2437
Practice Address - Country:US
Practice Address - Phone:507-377-6411
Practice Address - Fax:507-377-6443
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN303123101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)