Provider Demographics
NPI:1407643653
Name:MOLDE, ERICA JEAN (LSCSW)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:JEAN
Last Name:MOLDE
Suffix:
Gender:
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 SCHWEGLER DR RM 2150
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66045-7558
Mailing Address - Country:US
Mailing Address - Phone:785-864-2277
Mailing Address - Fax:
Practice Address - Street 1:1200 SCHWEGLER DR RM 2150
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66045-7558
Practice Address - Country:US
Practice Address - Phone:785-864-2277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS061291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical