Provider Demographics
NPI:1922317353
Name:SEARS, ERIKA A (LCSW)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:A
Last Name:SEARS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ERIKA
Other - Middle Name:A
Other - Last Name:GONZALEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:1611 AGUA DULCE DR SE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-8748
Mailing Address - Country:US
Mailing Address - Phone:575-649-4167
Mailing Address - Fax:
Practice Address - Street 1:1100 S MAIN ST STE 22
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88005-2917
Practice Address - Country:US
Practice Address - Phone:575-649-4167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-04
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMC-098731041C0700X
NMM-070881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM27826252Medicaid