Provider Demographics
NPI:1770864167
Name:HENLEY, ERIKA ELAINE
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:ELAINE
Last Name:HENLEY
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 1:175 HIGH TOP CIR W
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06514-4825
Mailing Address - Country:US
Mailing Address - Phone:203-668-4190
Mailing Address - Fax:
Practice Address - Street 1:175 HIGH TOP CIR W
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06514-4825
Practice Address - Country:US
Practice Address - Phone:203-668-4190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-30
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker