NPIMap

Organization Active NPI

Randi L. Erickson

  • Psychologist
  • Hudson, WI
National Provider Identifier
1376659201
Registry record updated Jul 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
RANDI L. ERICKSON
Practice address
2910 Enloe St
Suite 104
Hudson, WI 54016-4538
Phone
(715) 377-0000
Fax
(715) 377-0010
NPI assigned
Aug 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2008

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

Authorized official

Name
Dr. Randi L Erickson, PSY D LP
Title
Owner
Phone
(715) 377-0000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X Primary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X

Addresses

Primary practice location

2910 Enloe St
Suite 104
Hudson, WI 54016-4538

Mailing address

2910 Enloe St
Suite 104
Hudson, WI 54016-4538
Phone (715) 377-0000

Other identifiers 3

IdentifierTypeStateIssuer
1689778748OtherWIINDIVIDUAL NPI NUMBER
39147000MedicaidWI
1689778748MedicaidMN

Other names 1

  • Croix Counseling & Psychology Doing business as

National Provider Directory

National Provider Directory

Locations

2910 Enloe St
Ste 104
Hudson, WI 54016
Phone (715) 377-0000

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215648000000",
    "number": "1376659201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2910 ENLOE ST",
            "address_2": "SUITE 104",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540164538",
            "telephone_number": "715-377-0000",
            "fax_number": "715-377-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2910 ENLOE ST",
            "address_2": "SUITE 104",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540164538",
            "telephone_number": "715-377-0000",
            "fax_number": "715-377-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDI L. ERICKSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-22",
        "last_updated": "2008-07-10",
        "status": "A",
        "authorized_official_last_name": "ERICKSON",
        "authorized_official_first_name": "RANDI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "715-377-0000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY D LP"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI NUMBER",
            "identifier": "1689778748",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39147000",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689778748",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Croix Counseling & Psychology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hudson, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.