Provider Demographics
NPI:1730831777
Name:JONES, ERICA PATRICE (LGPC)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:PATRICE
Last Name:JONES
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5802 GIST AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-3528
Mailing Address - Country:US
Mailing Address - Phone:443-985-0681
Mailing Address - Fax:
Practice Address - Street 1:5430 CAMPBELL BLVD STE 113
Practice Address - Street 2:
Practice Address - City:WHITE MARSH
Practice Address - State:MD
Practice Address - Zip Code:21162-5503
Practice Address - Country:US
Practice Address - Phone:410-931-5010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-20
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP11916101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional