Provider Demographics
NPI:1265116636
Name:VENEZIA, ERICA L (LMSW)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:L
Last Name:VENEZIA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9520 BERGER RD STE 302
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-1540
Mailing Address - Country:US
Mailing Address - Phone:301-310-7005
Mailing Address - Fax:
Practice Address - Street 1:9520 BERGER RD STE 302
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-1540
Practice Address - Country:US
Practice Address - Phone:301-310-7005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-14
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD30200104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker