Healthcare Provider Details

I. General information

NPI: 1881178507
Provider Name (Legal Business Name): ERICKA NAEEMA MAHDI MSW,BEHAVIOR ANALYST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2018
Last Update Date: 07/07/2023
Certification Date: 07/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1339 RANDOLPH ST. NW
WASHINGTON DC
20011
US

IV. Provider business mailing address

1339 RANDOLPH ST. NW
WASHINGTON DC
20011
US

V. Phone/Fax

Practice location:
  • Phone: 202-389-7653
  • Fax:
Mailing address:
  • Phone: 202-389-7653
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: