Individual
ERICA MORTIMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
37LC00241100
NJ
101YP2500X
Professional Counselor
Primary
37C00533900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37LC00241100
LCADC LICENSE NUMBER
NJ
01
—
37PC00533900
LPC LICENSE NUMBER
NJ
Enumeration date
06/19/2018
Last updated
06/19/2018
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