Madison Elizabeth Ericksen, LCMHC

Individual provider Active NPI Professional Counselor · Black Mountain, NC

NPI 1093290751 · NPPES record last updated Jul 31, 2023

Key facts

NPI
1093290751
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
13817 (NC)
Practice address
305 N Dougherty St
Black Mountain, NC 28711-3353
Phone
(828) 406-0667
NPI assigned
Sep 28, 2018
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
13817NCMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 13817 NC
Professional Counselor 101YP2500X 13817 NC Yes

Addresses

Primary practice location

305 N Dougherty St
Black Mountain, NC 28711-3353

Mailing address

305 N Dougherty St
Black Mountain, NC 28711-3353
Phone (828) 406-0667

Other providers in Black Mountain, NC

All providers in Black Mountain, NC · Professional Counselor in North Carolina

Sources for this page

Verify at the official NPI Registry.