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General NPI Number Information
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NPI Number | 1518403625
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Entity Type | Individual
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Provider Name | ERIKA LATISHA HOLLIDAY LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/12/2017
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Last Update Date | 09/06/2023
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Provider Practice Location Address
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Address Line | 1500 BROOK RD
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City | RICHMOND
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State | VA
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Zip | 23220-2308
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Country | US
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Telephone | 804-225-9144
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Fax | 804-225-9145
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Provider Business Mailing Address
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Address Line | 13500 RIDGEMOOR DR
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City | MIDLOTHIAN
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State | VA
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Zip | 23114-5545
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Country | US
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Telephone | 804-908-0309
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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 | 0904008195
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License Number State | VA
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