Provider Demographics
NPI:1629266739
Name:WOJCIK, ERICA RICHELLE (LMSW)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:RICHELLE
Last Name:WOJCIK
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:RICHELLE
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:829 FOREST HILL AVE SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-2387
Mailing Address - Country:US
Mailing Address - Phone:616-949-2410
Mailing Address - Fax:616-949-9948
Practice Address - Street 1:5251 CLYDE PARK SW
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:MI
Practice Address - Zip Code:49509
Practice Address - Country:US
Practice Address - Phone:616-532-1100
Practice Address - Fax:616-249-2246
Is Sole Proprietor?:No
Enumeration Date:2007-10-15
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801082566104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker