MEDICARE: ERICA LEE 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
1	1041C0700X	Clinical Social Worker	L16335	OR
2	1041C0700X	Clinical Social Worker	LICSW1140682	MA
3	1041C0700X	Clinical Social Worker	64079	TX
4	1041C0700X	Clinical Social Worker	I.2506720	OH

General Provider Information

NPI Number	:	1790376531
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERICA LEE LCSW

Provider Business Mailing Address
First Line	:	1300 N CUSTER RD APT 1223
Second Line	:
City	:	ALLEN
State	:	TX
Zip	:	75013-3445
Country	:	US
Telephone Number	:	662-633-8183
Fax Number	:

Provider Business Practice Location Address
First Line	:	1300 N CUSTER RD APT 1223
Second Line	:
City	:	ALLEN
State	:	TX
Zip	:	75013-3445
Country	:	US
Telephone Number	:	662-633-8183
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2021
Last Update Date	:	03/02/2026

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Directions to “ ERICA LEE LCSW” Practice Location

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