Provider Demographics
NPI:1023765872
Name:SAUNDERS, ERICA MACK (MA)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:MACK
Last Name:SAUNDERS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6340 CENTER DR
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-4104
Mailing Address - Country:US
Mailing Address - Phone:757-739-5150
Mailing Address - Fax:703-649-3599
Practice Address - Street 1:6340 CENTER DR
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-4104
Practice Address - Country:US
Practice Address - Phone:757-466-5150
Practice Address - Fax:703-649-3599
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704014528101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health