Provider Demographics
NPI:1891893210
Name:BURNS, ERICA GENELL (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:GENELL
Last Name:BURNS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7533 MAIN ST
Mailing Address - Street 2:SUITE 1F
Mailing Address - City:SYKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21784-7374
Mailing Address - Country:US
Mailing Address - Phone:410-970-6964
Mailing Address - Fax:410-970-6157
Practice Address - Street 1:7533 MAIN ST
Practice Address - Street 2:SUITE 1F
Practice Address - City:SYKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21784-7374
Practice Address - Country:US
Practice Address - Phone:410-970-6964
Practice Address - Fax:410-970-6157
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD120851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical