Provider Demographics
NPI:1427776467
Name:THOMAS, ERICA DESHAUNE (LCSW)
Entity type:Individual
Prefix:MS
First Name:ERICA
Middle Name:DESHAUNE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:282 BIG LAKE RD APT 112
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39531-3711
Mailing Address - Country:US
Mailing Address - Phone:228-326-4535
Mailing Address - Fax:
Practice Address - Street 1:715A DIVISION ST
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39530-2209
Practice Address - Country:US
Practice Address - Phone:228-374-4991
Practice Address - Fax:228-436-3720
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-16
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSC75321041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty