Provider Demographics
NPI:1255710521
Name:SANDERS, ERICA JANAE TAYLOR (DSW, LCSW-S)
Entity type:Individual
Prefix:DR
First Name:ERICA
Middle Name:JANAE TAYLOR
Last Name:SANDERS
Suffix:
Gender:F
Credentials:DSW, LCSW-S
Other - Prefix:MS
Other - First Name:ERICA
Other - Middle Name:
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1692
Mailing Address - Street 2:
Mailing Address - City:RED OAK
Mailing Address - State:TX
Mailing Address - Zip Code:75154-1564
Mailing Address - Country:US
Mailing Address - Phone:214-932-5231
Mailing Address - Fax:
Practice Address - Street 1:2909 N BUCKNER BLVD
Practice Address - Street 2:STE 501
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75228-4861
Practice Address - Country:US
Practice Address - Phone:214-932-5231
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-20
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX54589171M00000X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator