Provider Demographics
NPI:1649790007
Name:CHICK, ERICA L (LCSW)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:L
Last Name:CHICK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:615 S. NEW BALLAS
Mailing Address - Street 2:MERCY HOSPITAL - CONWAY BUILDING
Mailing Address - City:ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141
Mailing Address - Country:US
Mailing Address - Phone:314-251-4919
Mailing Address - Fax:314-251-4120
Practice Address - Street 1:12125 CONWAY ROAD
Practice Address - Street 2:
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141
Practice Address - Country:US
Practice Address - Phone:314-251-2870
Practice Address - Fax:314-364-5452
Is Sole Proprietor?:No
Enumeration Date:2017-06-26
Last Update Date:2017-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0017271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical