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General NPI Number Information
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NPI Number | 1487892733
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Entity Type | Individual
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Provider Name | ERICA ELIZABETH GERRITY LICSW
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Gender | Female
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Dates
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Enumeration Date | 01/24/2009
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Last Update Date | 08/14/2012
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Provider Practice Location Address
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Address Line | 3450 OLEARY LN MN MENTAL HEALTH CLINICS
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City | EAGAN
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State | MN
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Zip | 55123-2340
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Country | US
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Telephone | 651-365-8218
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Fax |
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Provider Business Mailing Address
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Address Line | 447 MARNIE ST S
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City | MAPLEWOOD
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State | MN
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Zip | 55119-6756
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Country | US
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Telephone | 612-390-5235
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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 | 17555
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License Number State | MN
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