Geralds, Erica

Geralds, Erica is an sole proprietor health care provider with primary practice located at 4190 Peace Rose Pl , Loganville GA 30052-5112. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Counselor. Behavioral Health & Social Service Providers / Counselor is her primary health care specialty. Geralds, Erica can be contacted via phone (678) 640-3196.

Contact Information

Primary practice address
4190 Peace Rose Pl Loganville GA 30052-5112
Phone: (678) 640-3196
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 178.012703 Illinois
Behavioral Health & Social Service Providers / Counselor 101Y00000X LPC011071 Georgia

Profile Details

NPI number 1861926149
LBN Legal business name Geralds, Erica
Credentials MDIV, LPC, NCC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 13th, 2017
Last updated Nov 26th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861926149 NPPES
Illinois Other 1673042 BLUE CROSS BLUE SHIELD
Illinois MEDICAID 2A00-IPI-178 BLUE CROSS BLUE SHIELD

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