Provider Demographics
NPI:1326574781
Name:LICHILIN, ERICA CRAWFORD
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:CRAWFORD
Last Name:LICHILIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:CRAWFORD
Other - Last Name:DELAUNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:75153 CRESTVIEW HILLS LOOP
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70435-5678
Mailing Address - Country:US
Mailing Address - Phone:985-264-9344
Mailing Address - Fax:
Practice Address - Street 1:75153 CRESTVIEW HILLS LOOP
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70435-5678
Practice Address - Country:US
Practice Address - Phone:985-264-9344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-04
Last Update Date:2023-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)