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General NPI Number Information
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NPI Number | 1285884635
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Entity Type | Individual
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Provider Name | ERICA C ERNST LCSW, RDDP, CADC
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Gender | Female
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Dates
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Enumeration Date | 09/23/2008
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Last Update Date | 08/07/2014
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Provider Practice Location Address
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Address Line | 1740 RIDGE AVE 301
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City | EVANSTON
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State | IL
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Zip | 60201-5918
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Country | US
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Telephone | 773-425-1151
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Fax |
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Provider Business Mailing Address
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Address Line | 1740 RIDGE AVE 301
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City | EVANSTON
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State | IL
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Zip | 60201-5918
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Country | US
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Telephone | 773-425-1151
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149.014574
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 28920
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 29747
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 146L00000X
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Taxonomy Name | Paramedic
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License Number | 000519553
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License Number State | IL
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