Provider Demographics
NPI:1710449046
Name:DE LA CRUZ, ERIKA (MA, LCMHC, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:
Last Name:DE LA CRUZ
Suffix:
Gender:F
Credentials:MA, LCMHC, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:885 GOLD HILL ROAD
Mailing Address - Street 2:3004
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708-7214
Mailing Address - Country:US
Mailing Address - Phone:803-752-0106
Mailing Address - Fax:
Practice Address - Street 1:885 GOLD HILL ROAD
Practice Address - Street 2:3004
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29708-7214
Practice Address - Country:US
Practice Address - Phone:803-752-0106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA14747101YM0800X
SC9540101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health