Erica Renee Edge, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

4316 Issued in HI

Practice address

4007 Long Point Blvd
Portsmouth, VA 23703-5348

Phone

(808) 825-1650

NPI assigned

May 23, 2018

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Erica Renee Acotanza Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Fair Winds Therapy & Consulting Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Portsmouth, VA
  • NPI 1639969116
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1527033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697241600000",
    "number": "1790276954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4007 LONG POINT BLVD",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237035348",
            "telephone_number": "808-825-1650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4007 LONG POINT BLVD",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237035348",
            "telephone_number": "808-825-1650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDGE",
        "first_name": "ERICA",
        "middle_name": "RENEE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-23",
        "last_updated": "2023-10-14",
        "certification_date": "2023-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WV",
            "license": "DP00945484",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "HI",
            "license": "4316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERICA",
            "last_name": "ACOTANZA",
            "middle_name": "RENEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Eckerd Corporation (Rite Aid Pharmacy 11297)
• Eckerd Corporation (Rite Aid Pharmacy 11294)
• Christofer Ecklund, PSY.D.
• Nancy E Edenfield, LMFT
• Mia Edgar, MD
• Kathryn E Edman, AG-ACNP-BC
• Edmarc Inc.
• John T Edmonds, MD
• Andrew-Anthony Edwards, MD
• Elizabeth Edwards, NNP

• Clinical Social Worker in Portsmouth, VA
• Providers in Portsmouth, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.