Provider Demographics
NPI:1760876411
Name:LONDON, ERICA (MA LMFT)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:
Last Name:LONDON
Suffix:
Gender:F
Credentials:MA LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5115 NE 94TH AVE STE D
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-6180
Mailing Address - Country:US
Mailing Address - Phone:360-558-7730
Mailing Address - Fax:
Practice Address - Street 1:5115 NE 94TH AVE STE D
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-6180
Practice Address - Country:US
Practice Address - Phone:360-558-7730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-20
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health