Healthcare Provider Details

I. General information

NPI: 1831178847
Provider Name (Legal Business Name): ERICKA C WOODS PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2006
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 MEADOW DR
WATERFORD CT
06385-4344
US

IV. Provider business mailing address

18 MEADOW DR
WATERFORD CT
06385-4344
US

V. Phone/Fax

Practice location:
  • Phone: 917-674-1219
  • Fax:
Mailing address:
  • Phone: 917-674-1219
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number004419
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: