Provider Demographics
NPI:1063065241
Name:HUBBARD, ERIKA C (LCSW)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:C
Last Name:HUBBARD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ERIKA
Other - Middle Name:
Other - Last Name:MONZO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:411 CONGRESS ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04101-3505
Mailing Address - Country:US
Mailing Address - Phone:207-245-0700
Mailing Address - Fax:
Practice Address - Street 1:411 CONGRESS ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-3505
Practice Address - Country:US
Practice Address - Phone:297-245-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-17
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC18047104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker