Provider Demographics
NPI:1275192700
Name:ARDINGER, ERICA MACKENZIE (LCSW-C)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:MACKENZIE
Last Name:ARDINGER
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2317 OLD MAPLE CT
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-1768
Mailing Address - Country:US
Mailing Address - Phone:410-205-5052
Mailing Address - Fax:
Practice Address - Street 1:7130 MINSTREL WAY STE 125
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-5329
Practice Address - Country:US
Practice Address - Phone:410-205-5052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-09
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD24878104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker