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General NPI Number Information
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NPI Number | 1316828080
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Entity Type | Individual
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Provider Name | ERICA DINWIDDIE LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/10/2025
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 111 W JACKSON BLVD STE 1700
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City | CHICAGO
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State | IL
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Zip | 60604-3597
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Country | US
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Telephone | 646-941-7645
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 675471
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City | DETROIT
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State | MI
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Zip | 48267-5471
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Country | US
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Telephone |
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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 | LC200002414
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149025268
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License Number State | IL
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