Provider Demographics
NPI:1023291259
Name:THOMPSON, ERICA JOY (LCPC)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:JOY
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 BLOOMSBURY AVE
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4784
Mailing Address - Country:US
Mailing Address - Phone:443-612-1402
Mailing Address - Fax:
Practice Address - Street 1:22 BLOOMSBURY AVE
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-4784
Practice Address - Country:US
Practice Address - Phone:443-612-1403
Practice Address - Fax:443-830-1521
Is Sole Proprietor?:No
Enumeration Date:2007-12-11
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC3960101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6103809Medicaid
MDLC3960OtherMD STATE LICENSE
NC147V1OtherBCBS