Provider Demographics
NPI:1629731807
Name:TERRANA, ERICA LYNNE (LMSW)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:LYNNE
Last Name:TERRANA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 S 5TH ST
Mailing Address - Street 2:
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714-2507
Mailing Address - Country:US
Mailing Address - Phone:917-435-4930
Mailing Address - Fax:
Practice Address - Street 1:497 ROCKAWAY AVE
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11581-1909
Practice Address - Country:US
Practice Address - Phone:718-845-2621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-14
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker