Provider Demographics
NPI:1427743780
Name:MENDENHALL, ERIKA M (INTERN)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:M
Last Name:MENDENHALL
Suffix:
Gender:F
Credentials:INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 BAKERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35756-4369
Mailing Address - Country:US
Mailing Address - Phone:916-969-7063
Mailing Address - Fax:
Practice Address - Street 1:118 BAKERFIELD RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35756-4369
Practice Address - Country:US
Practice Address - Phone:916-969-7063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-11
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health