Provider Demographics
NPI:1841736519
Name:OLDHAM, ERIKA LAKEISHA (LCSW, LCAS)
Entity Type:Individual
Prefix:MS
First Name:ERIKA
Middle Name:LAKEISHA
Last Name:OLDHAM
Suffix:
Gender:F
Credentials:LCSW, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 SHELL LN
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-7941
Mailing Address - Country:US
Mailing Address - Phone:910-358-8132
Mailing Address - Fax:
Practice Address - Street 1:159 CHRISTY DR
Practice Address - Street 2:
Practice Address - City:BEULAVILLE
Practice Address - State:NC
Practice Address - Zip Code:28518-7711
Practice Address - Country:US
Practice Address - Phone:910-358-8132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-18
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0096131041C0700X
NCC011116104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical