Erica Renee Laub, MSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

27498 Issued in MN

Practice address

11990 Portland Ave
Burnsville, MN 55337-1516

Phone

(612) 217-4310

Fax

(952) 479-7896

NPI assigned

Jul 22, 2015

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1437523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1679958433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11990 PORTLAND AVE",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553371516",
            "telephone_number": "612-217-4310",
            "fax_number": "952-479-7896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11990 PORTLAND AVE",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553371516",
            "telephone_number": "612-217-4310",
            "fax_number": "952-479-7896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUB",
        "first_name": "ERICA",
        "middle_name": "RENEE",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-22",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MN",
            "license": "27498",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "27498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Marie Larson
• Jenna Lynn Larson
• Linda Larson, PTA
• Eric Latour
• Stephanie Latshaw
• Nicole Marie Lauer, D.C.
• Madeline Lavictoire
• Angela A Lawson
• Dahabo Layli
• Nghi Le

• Clinical Social Worker in Burnsville, MN
• Providers in Burnsville, 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 3, 2022; 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.