Provider Demographics
NPI:1629481122
Name:ROUSH, ERIKA (MSW, LGSW)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:
Last Name:ROUSH
Suffix:
Gender:F
Credentials:MSW, LGSW
Other - Prefix:
Other - First Name:ERIKA
Other - Middle Name:
Other - Last Name:RANDLETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1001 CROMWELL BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21286-3300
Mailing Address - Country:US
Mailing Address - Phone:410-491-5042
Mailing Address - Fax:
Practice Address - Street 1:1001 CROMWELL BRIDGE RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21286-3300
Practice Address - Country:US
Practice Address - Phone:410-491-5042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-03
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19727104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker