Provider Demographics
NPI:1710558770
Name:BOOKER, ERICA (LICSW, LCSW-C)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:BOOKER
Suffix:
Gender:F
Credentials:LICSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12810 STATON CT
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-1716
Mailing Address - Country:US
Mailing Address - Phone:301-996-4662
Mailing Address - Fax:
Practice Address - Street 1:12810 STATON CT
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-1716
Practice Address - Country:US
Practice Address - Phone:301-996-4662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-09
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500807561041C0700X
MD230181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical