Active NPI
Terra Erickson
- Counselor
- Longview, WA
National Provider Identifier
1619660057
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- CG61566813
- Practice address
- 720 14TH Ave
Longview, WA 98632 - Phone
- (360) 423-0203
- Fax
- (360) 577-0187
- NPI assigned
- May 31, 2023
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | CG61566813 | WA | Primary |
Addresses
Primary practice location
720 14TH Ave
Longview, WA 98632
Mailing address
Columbia Wellness
PO Box 1847
Longview, WA 98632
Phone (360) 353-9369
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CG61566813 | WA | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Columbia Wellness | Current | Accepting new patients |
Locations
720 14th Ave
Longview, WA 98632
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.
-
- Case Management Agency
- Longview, WA
- NPI 1487659579
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721779200000",
"number": "1619660057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "COLUMBIA WELLNESS",
"address_2": "PO BOX 1847",
"city": "LONGVIEW",
"state": "WA",
"postal_code": "98632",
"telephone_number": "360-353-9369",
"fax_number": "360-577-0187"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "720 14TH AVE",
"city": "LONGVIEW",
"state": "WA",
"postal_code": "98632",
"telephone_number": "360-423-0203",
"fax_number": "360-577-0187"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERICKSON",
"first_name": "TERRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-31",
"last_updated": "2024-07-24",
"certification_date": "2023-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WA",
"license": "CG61566813",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Longview, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.