Provider Demographics
NPI:1245719616
Name:MEAD, ERIKA NICOLE (CASAC-T)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:NICOLE
Last Name:MEAD
Suffix:
Gender:F
Credentials:CASAC-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 YEOMAN RD
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-2667
Mailing Address - Country:US
Mailing Address - Phone:845-245-8770
Mailing Address - Fax:
Practice Address - Street 1:942 ROUTE 376
Practice Address - Street 2:
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-6483
Practice Address - Country:US
Practice Address - Phone:845-765-2366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-07
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY34375101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor