Provider Demographics
NPI:1720567944
Name:SUTTON, ERICA GAYLE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ERICA
Middle Name:GAYLE
Last Name:SUTTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 FORT WORTH AVE APT 3019
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-0260
Mailing Address - Country:US
Mailing Address - Phone:469-216-2305
Mailing Address - Fax:
Practice Address - Street 1:2000 E LAMAR BLVD STE 530
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76006-7341
Practice Address - Country:US
Practice Address - Phone:214-519-9473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-08
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX57948101YM0800X
579481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health