John Raymond Erickson, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS007918L Issued in PA

Practice address

315 S Allen St
Suite 421
State College, PA 16801-4849

Phone

(814) 466-2133

Fax

(814) 826-2585

NPI assigned

Aug 16, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• Erickson Psychological Services LLC

  • Clinical Psychologist
  • State College, PA
  • NPI 1679963193

  Clinical, PA

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482192000000",
    "number": "1366434466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 S ALLEN ST",
            "address_2": "SUITE 421",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168014849",
            "telephone_number": "814-466-2133",
            "fax_number": "814-826-2585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 S ALLEN ST",
            "address_2": "SUITE 421",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168014849",
            "telephone_number": "814-466-2133",
            "fax_number": "814-826-2585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "JOHN",
        "middle_name": "RAYMOND",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2016-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS007918L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Erica Wiley PHD LLC
• Erickson Psychological Services LLC
• Allison B. Ermol, PA-C
• Ethan Eric Ernst, PA-C
• Susan Carol Eshelman, R.PH.
• Amanda C. Evans, M.S., L.P.C.
• Christopher R Evans, PHARMD, BCACP

• All providers in State College, PA
• Clinical Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.