Individual provider Active NPI

Robin Erickson, MS, LCMHC

  • Mental Health Counselor
  • Jeffersonville, VT
National Provider Identifier
1104361476
Registry record updated Mar 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
06810057624 Issued in VT
Practice address
22 Old Main St
Jeffersonville, VT 05464-8100
Phone
(802) 730-4175
NPI assigned
Dec 22, 2016
Last updated
Mar 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 06810057624 VT Primary
Mental Health Counselor 101YM0800X VT

Addresses

Primary practice location

22 Old Main St
Jeffersonville, VT 05464-8100

Mailing address

4889 East Bakersfield Rd.
Enosburg Falls, VT 05450
Phone (802) 730-4175

Other identifiers 1

IdentifierTypeStateIssuer
1029302MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Nov 19, 2025 through Nov 19, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
06810057624VTMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1482364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1104361476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4889 EAST BAKERSFIELD RD.",
            "city": "ENOSBURG FALLS",
            "state": "VT",
            "postal_code": "05450",
            "telephone_number": "802-730-4175",
            "fax_number": "802-888-6393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 OLD MAIN ST",
            "city": "JEFFERSONVILLE",
            "state": "VT",
            "postal_code": "054648100",
            "telephone_number": "802-730-4175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "ROBIN",
        "name_prefix": "Mrs.",
        "credential": "MS, LCMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-22",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VT",
            "license": "06810057624",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VT",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1029302",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jeffersonville, VT

Sources for this page

Verify at the official NPI Registry.