Active NPI
Erica Bolin Weseman, LCSW
- Clinical Social Worker
- Houston, TX
National Provider Identifier
1104020098
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 57303
- Practice address
- 9401 Southwest Fwy
Houston, TX 77074-1407 - Phone
- (713) 970-7000
- Fax
- (713) 970-7246
- NPI assigned
- Jun 13, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 2337G | AL | |
| Counselor | 101Y00000X | 2337G | AL | |
| Clinical Social Worker | 1041C0700X | 2248C | AL | |
| Clinical Social Worker | 1041C0700X | 57303 | TX | Primary |
Addresses
Primary practice location
9401 Southwest Fwy
Houston, TX 77074-1407
Mailing address
2409 Homer Clayton Dr
Guntersville, AL 35976-2207
Phone (256) 582-3203
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51541444 | Other | AL | BCBS |
| 312423201 | Medicaid | TX |
Other names 1
- Erica Opal Bolin
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2337G | AL | MD | Counselor |
| 57303 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493596800000",
"number": "1104020098",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2409 HOMER CLAYTON DR",
"city": "GUNTERSVILLE",
"state": "AL",
"postal_code": "359762207",
"telephone_number": "256-582-3203",
"fax_number": "256-582-3216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9401 SOUTHWEST FWY",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770741407",
"telephone_number": "713-970-7000",
"fax_number": "713-970-7246"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WESEMAN",
"first_name": "ERICA",
"middle_name": "BOLIN",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-13",
"last_updated": "2017-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "AL",
"license": "2337G",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "AL",
"license": "2337G",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AL",
"license": "2248C",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "57303",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "51541444",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "312423201",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ERICA",
"last_name": "BOLIN",
"middle_name": "OPAL",
"credential": "LGSW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.