Healthcare Provider Details
I. General information
NPI: 1992425805
Provider Name (Legal Business Name): ERICA NORTH
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/31/2022
Last Update Date: 06/12/2023
Certification Date: 06/12/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7809 AIRLINE DR STE 305A
METAIRIE LA
70003-6448
US
IV. Provider business mailing address
7809 AIRLINE DR STE 305A
METAIRIE LA
70003-6448
US
V. Phone/Fax
- Phone: 504-267-1234
- Fax: 504-324-2094
- Phone: 504-267-1234
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | NULL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | |
| License Number State | LA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: