Provider Demographics
NPI:1942459847
Name:WHITT, ERICA R (LISW)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:R
Last Name:WHITT
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:R
Other - Last Name:COSH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LISW
Mailing Address - Street 1:PO BOX 5158
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29304-5158
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:460 LANGDON ST
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29302-1614
Practice Address - Country:US
Practice Address - Phone:864-582-2411
Practice Address - Fax:864-764-1336
Is Sole Proprietor?:No
Enumeration Date:2008-09-16
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC94031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC121328Medicaid
SC121328Medicaid