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General NPI Number Information
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NPI Number | 1225671894
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Entity Type | Individual
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Provider Name | ERICA BLACKWELL
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Gender | Female
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Dates
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Enumeration Date | 10/25/2019
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Last Update Date | 01/28/2026
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Provider Practice Location Address
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Address Line | 100 LAKEVIEW PARK RD APT 44
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City | COLONIAL HEIGHTS
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State | VA
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Zip | 23834-1688
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Country | US
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Telephone | 804-641-0024
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Fax |
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Provider Business Mailing Address
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Address Line | 159 CROCKER PARK BLVD STE 400
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City | WESTLAKE
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State | OH
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Zip | 44145-8147
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Country | US
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Telephone | 513-513-6237
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State | VA
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