JEREMY ERICKSON MAMFTC NPI 1396225504

NPI Information

  • NPI: 1396225504
  • Provider Name: JEREMY ERICKSON, MAMFTC
  • Classification: Counselor - 101YP2500X
  • Specialization: Professional
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 232 GOODMAN RD W STE 305
    SOUTHAVEN, MS
    ZIP 38671
  • Phone: (662) 856-9563

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NPI Details

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 NPI 1396225504 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

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
1101YP2500XCounselorProfessional2608MISSISSIPPIYes
2101YP2500XCounselorProfessionalA1708258ARKANSASNo

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: 11/21/2025

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