Phyllis J Erickson, RC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW00008499 Issued in WA

Practice address

1 Colville Street
Nespelem, WA 99155-0150

Phone

(509) 634-2727

Fax

(509) 634-2781

NPI assigned

Apr 23, 2007

Last updated

Oct 26, 2011By 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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319587200000",
    "number": "1659599033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 COLVILLE STREET",
            "city": "NESPELEM",
            "state": "WA",
            "postal_code": "991550150",
            "telephone_number": "509-634-2727",
            "fax_number": "509-634-2781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COLVILLE STREET",
            "city": "NESPELEM",
            "state": "WA",
            "postal_code": "991550150",
            "telephone_number": "509-634-2727",
            "fax_number": "509-634-2781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "PHYLLIS",
        "middle_name": "J",
        "credential": "RC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2011-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "RC00028461",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW00008499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1980812",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• DHHS IHS Colville Service Unit (Colville Indian Health Center)
• Linda Lorraine Dick, RC
• DSSH IHS Colville Service Unit (Colville Indian Health Center)
• Katrina Duncan
• Rayna J Edwards, EMT-B
• Lawrence J Fry Sr., CDP
• Andrea Gatlin, RN
• Kirk Gatlin, RN
• Dawn Elaine George, RN
• Suzanne Conrad Gnaegy, D.O

• Clinical Social Worker in Nespelem, WA
• Providers in Nespelem, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2011; 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.