Shannon Ericson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW020926 Issued in PA

Practice address

811 N Hancock St
Philadelphia, PA 19123-3014

Phone

(908) 763-7562

NPI assigned

Feb 6, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1580947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580947200000",
    "number": "1629600820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 N HANCOCK ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191233014",
            "telephone_number": "908-763-7562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 N HANCOCK ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191233014",
            "telephone_number": "908-763-7562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICSON",
        "first_name": "SHANNON",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-06",
        "last_updated": "2020-02-06",
        "certification_date": "2020-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW020926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shannon.ericson@pennmedicine.upenn.edu",
            "affiliation": "N",
            "address_1": "811 N Hancock St",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191233014",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "sericson.lcsw@gmail.com",
            "affiliation": "N",
            "address_1": "811 N Hancock St",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191233014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Erica M Brendel MD PC
• Marianne Erick, CRNP
• Jennifer Anne Erickson, N.P.
• Joshua Erickson, M.D.
• Kelley Annette Erickson, CRNP
• Erie Avenue Chiropractic Center
• Whitney Taylor Eriksen, PHD CRNP
• Neal Erkes, M.D.
• Cherie Pwu Parungo Erkmen, M.D.
• Kadir Erkmen, M.D.

• All providers in Philadelphia, PA
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2020; 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.