Provider Demographics
NPI:1790347359
Name:MORRIS, ERICA R
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:R
Last Name:MORRIS
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 1:464 TORTOISE LN
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27127-7006
Mailing Address - Country:US
Mailing Address - Phone:336-575-4649
Mailing Address - Fax:
Practice Address - Street 1:333 S MAIN ST # 706
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44308-1202
Practice Address - Country:US
Practice Address - Phone:336-896-1324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-03
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health