Provider Demographics
NPI:1285953299
Name:SODERBERG, ERICA D (MSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:ERICA
Middle Name:D
Last Name:SODERBERG
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1630 E HIGH ST
Mailing Address - Street 2:BLDG 4
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-3244
Mailing Address - Country:US
Mailing Address - Phone:610-327-1631
Mailing Address - Fax:610-327-1199
Practice Address - Street 1:1630 E HIGH ST
Practice Address - Street 2:BLDG 4
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-3244
Practice Address - Country:US
Practice Address - Phone:610-327-1631
Practice Address - Fax:610-327-1199
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-01
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0067401041C0700X
PACW0181221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical