Healthcare Provider Details

I. General information

NPI: 1275255648
Provider Name (Legal Business Name): MS. ERIKA LESLIE HUME
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2022
Last Update Date: 09/13/2022
Certification Date: 09/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SALEM OUTPATIENT AND COMMUNITY BEHAVIORAL HEALTH CLINIC 35 CONGRESS ST STE 225
SALEM MA
01970
US

IV. Provider business mailing address

SALEM OUTPATIENT AND COMMUNITY BEHAVIORAL HEALTH CLINIC 35 CONGRESS ST STE 225
SALEM MA
01970
US

V. Phone/Fax

Practice location:
  • Phone: 508-521-2200
  • Fax:
Mailing address:
  • Phone: 508-521-2200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: