Erica D Southworth

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LGP5537 Issued in MD

Practice address

23077 Three Notch Rd Ste 302
California, MD 20619-2453

Phone

(240) 237-8338

NPI assigned

Jan 5, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1483574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483574400000",
    "number": "1861937435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23077 THREE NOTCH RD STE 302",
            "city": "CALIFORNIA",
            "state": "MD",
            "postal_code": "206192453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23077 THREE NOTCH RD STE 302",
            "city": "CALIFORNIA",
            "state": "MD",
            "postal_code": "206192453",
            "telephone_number": "240-237-8338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHWORTH",
        "first_name": "ERICA",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-05",
        "last_updated": "2017-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MD",
            "license": "300225",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LGP5537",
            "primary": true
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "MD",
            "license": "1870",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigayle Smith
• Brianna Smith
• Robert L Smith, D.C.
• Kelly Smouse, AU.D.
• Michaela Smyth, BCBA
• Sydney Lane Sowers, PA-C
• N Spadavecchia, OTR/L
• Malia Speight
• Kari Staley, BCBA
• Kathleen Rose Stark, LCSW-C

• Professional Counselor in California, MD
• Providers in California, MD by specialty
• Professional Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 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.

Verify at the official NPI Registry.