Erica Wickoda, MSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

29604 Issued in MN

Practice address

4305 41St Ave S
Minneapolis, MN 55406-4037

Phone

(612) 412-1453

NPI assigned

Feb 28, 2018

Last updated

May 24, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Erica Wickstrom Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jewish Family Service

  • Voluntary or Charitable Agency
  • Seattle, WA
  • NPI 1760580187
  NPD (past)

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

{
    "created_epoch": "1519776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1578064101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 E 48TH ST STE 2",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554195651",
            "telephone_number": "612-412-1453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4305 41ST AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554064037",
            "telephone_number": "612-412-1453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKODA",
        "first_name": "ERICA",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-28",
        "last_updated": "2023-05-24",
        "certification_date": "2022-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "29604",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "SC60832295",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERICA",
            "last_name": "WICKSTROM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Christopher Wicker II
• David Anthony Wicklund
• Rebecca Wicklund, PT
• Richard G Wicklund, MD
• Taylor Marie Wicklund
• Kelly Wicks, PSY.D., LP
• Lisa A Wicktor, MA CCC SLP
• Kristine Widboom, PHARM.D.
• Rena Ann Widboom, D.C.
• Alik Sunil Widge, M.D., PH.D.

• Clinical Social Worker in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; 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.