Individual provider Active NPI

Sally Ann Erickson, LMHC

  • Counselor
  • Altamonte Springs, FL
National Provider Identifier
1720541436
Registry record updated Apr 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
MH7178 Issued in FL
Practice address
800 Maitland Ave
Altamonte Springs, FL 32701-6837
Phone
(407) 331-7911
Fax
(407) 971-2289
NPI assigned
Apr 9, 2019
Last updated
Apr 9, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X MH7178 FL Primary

Addresses

Primary practice location

800 Maitland Ave
Altamonte Springs, FL 32701-6837

Mailing address

800 Maitland Ave
Altamonte Springs, FL 32701-6837
Phone (407) 331-7911

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Mar 18, 2024 through Mar 18, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MH7178FLMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1554768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554768000000",
    "number": "1720541436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 MAITLAND AVE",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327016837",
            "telephone_number": "407-331-7911",
            "fax_number": "407-971-2289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MAITLAND AVE",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327016837",
            "telephone_number": "407-331-7911",
            "fax_number": "407-971-2289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "SALLY",
        "middle_name": "ANN",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-09",
        "last_updated": "2019-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "FL",
            "license": "MH7178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altamonte Springs, FL

Sources for this page

Verify at the official NPI Registry.