Provider Demographics
NPI:1700655008
Name:KERR SUED, ERICA BLAIR (LCMHCA)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:BLAIR
Last Name:KERR SUED
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:MISS
Other - First Name:ERICA
Other - Middle Name:BLAIR
Other - Last Name:KERR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6849 FAIRVIEW RD STE 702
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-3393
Mailing Address - Country:US
Mailing Address - Phone:980-308-4500
Mailing Address - Fax:980-458-6037
Practice Address - Street 1:6849 FAIRVIEW RD STE 702
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-3393
Practice Address - Country:US
Practice Address - Phone:980-308-4500
Practice Address - Fax:980-458-6037
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-28
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA19490101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health