Provider Demographics
NPI:1285884635
Name:ERNST, ERICA C (LCSW, RDDP, CADC)
Entity type:Individual
Prefix:MS
First Name:ERICA
Middle Name:C
Last Name:ERNST
Suffix:
Gender:F
Credentials:LCSW, RDDP, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1740 RIDGE AVE
Mailing Address - Street 2:301
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-5918
Mailing Address - Country:US
Mailing Address - Phone:773-425-1151
Mailing Address - Fax:
Practice Address - Street 1:1740 RIDGE AVE
Practice Address - Street 2:301
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-5918
Practice Address - Country:US
Practice Address - Phone:773-425-1151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-23
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0145741041C0700X
IL28920101YA0400X
IL29747101YA0400X
IL000519553146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic