Provider Demographics
NPI:1780483305
Name:ACKERMAN, ERICA (LSW, LCADC)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:ACKERMAN
Suffix:
Gender:
Credentials:LSW, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 DOGWOOD LN
Mailing Address - Street 2:
Mailing Address - City:BUSHKILL
Mailing Address - State:PA
Mailing Address - Zip Code:18324-6848
Mailing Address - Country:US
Mailing Address - Phone:973-558-0362
Mailing Address - Fax:
Practice Address - Street 1:1140 DOGWOOD LN
Practice Address - Street 2:
Practice Address - City:BUSHKILL
Practice Address - State:PA
Practice Address - Zip Code:18324-6848
Practice Address - Country:US
Practice Address - Phone:973-558-0362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-08
Last Update Date:2025-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL07106800104100000X
NJ37LC00336400101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker