MS. JENNIFER LYNN ERICSON MSW APSW RADC-I NPI 1386729218

NPI Information

NPI: 1386729218
Provider Name: MS. JENNIFER LYNN ERICSON, MSW, APSW, RADC-I
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
10045 W LISBON AVE STE 221
WAUWATOSA, WI
ZIP 53222
Phone: (414) 358-7144
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MS. Jennifer Lynn Ericson, MSW, APSW, RADC-I is an addiction (substance use disorder) counselor in Wauwatosa, WI. MS. Jennifer Lynn Ericson, MSW, APSW, RADC-I NPI is 1386729218. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

10045 W LISBON AVE STE 221
WAUWATOSA, WI
ZIP 53222-446
Phone: (414) 358-7144
Fax: (414) 358-7158

The enumeration date for this NPI number is 10/26/2006 and was last updated on 7/9/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	13566	WISCONSIN	Yes
2	106H00000X	Marriage & Family Therapist			WISCONSIN	X

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	13566	OTHER	WISCONSIN	WCB-RADC-I
2	43704900	MEDICAID	WISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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