Provider Demographics
NPI:1174140826
Name:SOWELL, ERICK JEROME (LCSW-C)
Entity type:Individual
Prefix:MR
First Name:ERICK
Middle Name:JEROME
Last Name:SOWELL
Suffix:
Gender:M
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1414 KEY HWY
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230-5189
Mailing Address - Country:US
Mailing Address - Phone:443-712-7128
Mailing Address - Fax:
Practice Address - Street 1:1414 KEY HWY
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21230-5189
Practice Address - Country:US
Practice Address - Phone:443-712-7128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-29
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD261101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical