| Deborah K Erickson Pllc | |
|
2151 Hamline Ave N Ste 204 Roseville MN 55113-4226 | |
| (651) 800-1127 | |
| (763) 703-3725 |
| Full Name | Deborah K Erickson Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 2151 Hamline Ave N Ste 204, Roseville, Minnesota |
| Authorized Official Name and Position | Deborah Kay Erickson (OWNER) |
| Authorized Official Contact | 6514851025 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Deborah K Erickson Pllc 1162 Englewood Ave Saint Paul MN 55104-1411 Ph: (651) 485-1025 | Deborah K Erickson Pllc 2151 Hamline Ave N Ste 204 Roseville MN 55113-4226 Ph: (651) 800-1127 |
| NPI Number | 1427571256 |
|---|---|
| Provider Enumeration Date | 07/24/2017 |
| Last Update Date | 05/13/2019 |
| Medicare PECOS PAC ID | 5294082244 |
|---|---|
| Medicare Enrollment ID | O20180720002817 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427571256 | NPI | - | NPPES |
| 1285929968 | Other | NPI INDIVIDUAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 17401 (Minnesota) | Primary |
| Provider Name | Deborah K Erickson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285929968 PECOS PAC ID: 7810119054 Enrollment ID: I20141104000655 |
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