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NPI Code Detail

MEDICARE: ERICA NEW LCSW

MEDICARE: ERICA NEW LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598088817
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERICA NEW LCSW
Provider Business Mailing Address
First Line : 925 STATE ROUTE VV
Second Line :
City : KENNETT
State : MO
Zip : 63857-3822
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1226 INDEPENDENCE AVE
Second Line :
City : KENNETT
State : MO
Zip : 63857-1316
Country : US
Telephone Number : 573-559-2380
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2010
Last Update Date : 08/12/2024

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Directions to “ ERICA NEW LCSW” Practice Location

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