Provider Demographics
NPI:1619380565
Name:SMITH, ERICA LEA (LMHC, LCPC)
Entity type:Individual
Prefix:MS
First Name:ERICA
Middle Name:LEA
Last Name:SMITH
Suffix:
Gender:F
Credentials:LMHC, LCPC
Other - Prefix:MS
Other - First Name:ERICA
Other - Middle Name:LEA
Other - Last Name:EVERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:12102 4TH AVE W APT 24-101
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98204-6410
Mailing Address - Country:US
Mailing Address - Phone:702-467-5271
Mailing Address - Fax:
Practice Address - Street 1:2720 N TENAYA WAY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0424
Practice Address - Country:US
Practice Address - Phone:702-228-4257
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-09
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH12473101YM0800X
NVCPC0219101YM0800X
WALH61405149101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL012097000Medicaid