Provider Demographics
NPI:1972273753
Name:NORRIS, ERICKA NICOLE (LSW)
Entity Type:Individual
Prefix:
First Name:ERICKA
Middle Name:NICOLE
Last Name:NORRIS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 COOK AVE
Mailing Address - Street 2:
Mailing Address - City:SCOTCH PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07076-1217
Mailing Address - Country:US
Mailing Address - Phone:917-841-6353
Mailing Address - Fax:
Practice Address - Street 1:308 COOK AVE
Practice Address - Street 2:
Practice Address - City:SCOTCH PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07076-1217
Practice Address - Country:US
Practice Address - Phone:917-841-6353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-14
Last Update Date:2021-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06622500104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ44SL06622500OtherNJ DIVISION OF CONSUMER AFFAIRS - SOCIAL WORKER LICENSE NUMBER