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General NPI Number Information
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NPI Number | 1467004036
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Entity Type | Individual
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Provider Name | ERIC LEE JAMES LMSW
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Gender | Male
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Dates
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Enumeration Date | 07/12/2019
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 1636 POPPS FERRY RD STE 203
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City | BILOXI
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State | MS
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Zip | 39532-2309
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Country | US
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Telephone | 228-284-2644
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Fax |
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Provider Business Mailing Address
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Address Line | 1636 POPPS FERRY RD STE 203
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City | BILOXI
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State | MS
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Zip | 39532-2309
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Country | US
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Telephone | 228-284-2644
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | M11169
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 2885
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License Number State | MS
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