Provider Demographics
NPI:1750845210
Name:YOUNG, ERIKA L
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:L
Last Name:YOUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4073
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33677-4073
Mailing Address - Country:US
Mailing Address - Phone:813-323-0605
Mailing Address - Fax:
Practice Address - Street 1:4480 51ST ST W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34210-2855
Practice Address - Country:US
Practice Address - Phone:941-251-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-29
Last Update Date:2022-05-17
Deactivation Date:2022-04-12
Deactivation Code:
Reactivation Date:2022-05-13
Provider Licenses
StateLicense IDTaxonomies
FL188021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical