George Donald Erickson, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2005031912 Issued in MO

Practice address

340 Kelley Pkwy
Mexico, MO 65265

Phone

(573) 582-1234

Fax

(573) 582-1212

NPI assigned

Oct 26, 2005

Reactivated

Mar 26, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567987200000",
    "number": "1437149812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 KELLEY PKWY",
            "city": "MEXICO",
            "state": "MO",
            "postal_code": "652653811",
            "telephone_number": "573-582-1234",
            "fax_number": "573-582-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 KELLEY PKWY",
            "city": "MEXICO",
            "state": "MO",
            "postal_code": "65265",
            "telephone_number": "573-582-1234",
            "fax_number": "573-582-1212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3401 Berrywood Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MO",
            "postal_code": "652016515",
            "country_code": "US",
            "telephone_number": "573-777-8330",
            "fax_number": "573-777-8390",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "509 W Rollins St",
            "address_2": "Suite 108",
            "address_purpose": "LOCATION",
            "city": "Moberly",
            "state": "MO",
            "postal_code": "65270",
            "country_code": "US",
            "telephone_number": "660-263-0680",
            "fax_number": "660-263-1890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "GEORGE",
        "middle_name": "DONALD",
        "name_prefix": "Mr.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-26",
        "last_updated": "2019-09-09",
        "deactivation_date": "2006-04-06",
        "reactivation_date": "2007-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2005031912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "497474502",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• East Central Missouri Behavioral Health Services, Inc.
• East Central Missouri Behavioral Health Services, Inc.
• Ashton Leigh Eibel, LPC
• Whitnee Eisele, N.P.
• Wendy Ell, OT
• Patricia Ann Erwin, LCSW
• Ebony Evans, NP-FNP
• Evergreen Behavioral Services, LLC
• Evergreen Behavioral Services, LLC
• Eye to Eye Optometry, Inc

• Clinical Social Worker in Mexico, MO
• Providers in Mexico, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2019; 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.