Provider Demographics
NPI:1194089417
Name:WHITE, ERICA LATRICE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:LATRICE
Last Name:WHITE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:ERICA
Other - Middle Name:LATRICE
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:4300 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-5446
Mailing Address - Country:US
Mailing Address - Phone:501-257-1000
Mailing Address - Fax:
Practice Address - Street 1:4300 W 7TH ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5446
Practice Address - Country:US
Practice Address - Phone:501-257-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-02
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2072-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical