Active NPI
Carol Jane Erickson, PSY.D.
- Psychologist
- Cheyenne, WY
National Provider Identifier
1255537296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 303
- Practice address
- 620 W 19TH St
Ste 6
Cheyenne, WY 82001-4307 - Phone
- (307) 637-5808
- Fax
- (307) 432-6775
- NPI assigned
- Jun 26, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 303 | WY | Primary |
Addresses
Primary practice location
620 W 19TH St
Ste 6
Cheyenne, WY 82001-4307
Mailing address
620 W 19TH St
Ste 6
Cheyenne, WY 82001-4307
Phone (307) 637-5808
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 310907 | Other | WY | BC/BS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 303 | WY | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carol J. Erickson, PSYD., P.C. | Psychologist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Psychologist
- Cheyenne, WY
- NPI 1912937749
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182816000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190592000000",
"number": "1255537296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "620 W 19TH ST",
"address_2": "STE 6",
"city": "CHEYENNE",
"state": "WY",
"postal_code": "820014307",
"telephone_number": "307-637-5808",
"fax_number": "307-432-6775"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 W 19TH ST",
"address_2": "STE 6",
"city": "CHEYENNE",
"state": "WY",
"postal_code": "820014307",
"telephone_number": "307-637-5808",
"fax_number": "307-432-6775"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERICKSON",
"first_name": "CAROL",
"middle_name": "JANE",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-26",
"last_updated": "2007-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WY",
"license": "303",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "310907",
"state": "WY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cheyenne, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.