Provider Demographics
NPI:1265109276
Name:PERSAUD, ERICA JEAN (MED, LPCMH, NCC)
Entity type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:JEAN
Last Name:PERSAUD
Suffix:
Gender:F
Credentials:MED, LPCMH, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32041 N SUMMER CT
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:DE
Mailing Address - Zip Code:19956-3486
Mailing Address - Country:US
Mailing Address - Phone:940-782-4923
Mailing Address - Fax:
Practice Address - Street 1:404 S BEDFORD ST STE 9
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:DE
Practice Address - Zip Code:19947-1885
Practice Address - Country:US
Practice Address - Phone:302-856-9578
Practice Address - Fax:302-856-9578
Is Sole Proprietor?:No
Enumeration Date:2021-08-26
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC-OO11081101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health