Provider Demographics
NPI:1578957999
Name:MADLOCK, ERICA N (LCSW)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:N
Last Name:MADLOCK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7011 SOUTHWEST FWY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-2007
Mailing Address - Country:US
Mailing Address - Phone:713-970-7000
Mailing Address - Fax:713-970-3394
Practice Address - Street 1:7011 SOUTHWEST FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-2007
Practice Address - Country:US
Practice Address - Phone:713-970-7000
Practice Address - Fax:713-970-3394
Is Sole Proprietor?:No
Enumeration Date:2015-03-24
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX548441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical