JEREMY ERICKSON MAMFTC NPI 1396225504

NPI Information

NPI: 1396225504
Provider Name: JEREMY ERICKSON, MAMFTC
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

Address:
232 GOODMAN RD W STE 305
SOUTHAVEN, MS
ZIP 38671
Phone: (662) 856-9563
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Jeremy Erickson, MAMFTC is a professional counselor in Southaven, MS. Jeremy Erickson, MAMFTC NPI is 1396225504. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

232 GOODMAN RD W STE 305
SOUTHAVEN, MS
ZIP 38671-004
Phone: (662) 856-9563

The enumeration date for this NPI number is 8/16/2018 and was last updated on 4/3/2024.

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	101YP2500X	Counselor	Professional	2608	MISSISSIPPI	Yes
2	101YP2500X	Counselor	Professional	A1708258	ARKANSAS	No

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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