Provider Demographics
NPI:1811474620
Name:WARREN, ERICA ANNETTE
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:ANNETTE
Last Name:WARREN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 MARS HILL COMMONS LN APT 203
Mailing Address - Street 2:
Mailing Address - City:MARS HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28754-0199
Mailing Address - Country:US
Mailing Address - Phone:434-429-6685
Mailing Address - Fax:
Practice Address - Street 1:36 MARS HILL COMMONS LN APT 203
Practice Address - Street 2:
Practice Address - City:MARS HILL
Practice Address - State:NC
Practice Address - Zip Code:28754-0199
Practice Address - Country:US
Practice Address - Phone:434-429-6685
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-24
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health