Provider Demographics
NPI:1720837131
Name:HERRERA, ERIKA MARCELA (LSW)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:MARCELA
Last Name:HERRERA
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 BLAUVELT AVE
Mailing Address - Street 2:
Mailing Address - City:BERGENFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07621-1206
Mailing Address - Country:US
Mailing Address - Phone:732-763-2361
Mailing Address - Fax:
Practice Address - Street 1:24 BLAUVELT AVE
Practice Address - Street 2:
Practice Address - City:BERGENFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07621-1206
Practice Address - Country:US
Practice Address - Phone:732-763-2361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-16
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06480400104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty