Provider Demographics
NPI:1831511195
Name:SANDILAND, ERICA (LCSW)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:SANDILAND
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 1:1001 SW HIGGINS AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59803-1340
Mailing Address - Country:US
Mailing Address - Phone:064-431-9401
Mailing Address - Fax:888-248-9401
Practice Address - Street 1:1001 SW HIGGINS AVE STE 206
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59803-1340
Practice Address - Country:US
Practice Address - Phone:406-431-9401
Practice Address - Fax:888-248-9203
Is Sole Proprietor?:No
Enumeration Date:2014-01-06
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1056104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker