Provider Demographics
NPI:1245898840
Name:JOHNSON, ERICA R (LCSWC)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:R
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LCSWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7252 STONY BARR RD
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-1958
Mailing Address - Country:US
Mailing Address - Phone:443-960-3874
Mailing Address - Fax:
Practice Address - Street 1:7252 STONY BARR RD
Practice Address - Street 2:
Practice Address - City:WINDSOR MILL
Practice Address - State:MD
Practice Address - Zip Code:21244-1958
Practice Address - Country:US
Practice Address - Phone:443-960-3874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-30
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD24748104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker