Provider Demographics
NPI:1689119661
Name:GILYARD, ERICA (BS, MHA)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:GILYARD
Suffix:
Gender:F
Credentials:BS, MHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 WALES RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-1816
Mailing Address - Country:US
Mailing Address - Phone:803-360-0518
Mailing Address - Fax:803-865-9435
Practice Address - Street 1:2801 WALES ROAD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-1816
Practice Address - Country:US
Practice Address - Phone:803-360-0518
Practice Address - Fax:803-865-9435
Is Sole Proprietor?:No
Enumeration Date:2016-12-29
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health