Provider Demographics
NPI:1386733137
Name:ERLY, KATHERINE JEANNE (LCSWC)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:JEANNE
Last Name:ERLY
Suffix:
Gender:F
Credentials:LCSWC
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:JEANNE
Other - Last Name:LOIACONO ERLY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSWC
Mailing Address - Street 1:481 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678-3340
Mailing Address - Country:US
Mailing Address - Phone:443-550-9559
Mailing Address - Fax:
Practice Address - Street 1:481 MAIN ST
Practice Address - Street 2:
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-3340
Practice Address - Country:US
Practice Address - Phone:443-550-9559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD106551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical