Jerry Martin Erickson Jr., LAC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A2009118 Issued in AR

Practice address

4702 W Commercial Dr Ste B3
North Little Rock, AR 72116-7073

Phone

(501) 205-4570

NPI assigned

Feb 4, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Central Arkansas Group Counseling, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bentonville, AR
  • NPI 1356867303
  NPD

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

{
    "created_epoch": "1612396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612396800000",
    "number": "1821680505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 ODOM RD",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720329031",
            "telephone_number": "910-286-2441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4702 W COMMERCIAL DR STE B3",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721167073",
            "telephone_number": "501-205-4570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "109 N Main St",
            "address_purpose": "LOCATION",
            "city": "Benton",
            "state": "AR",
            "postal_code": "720153764",
            "country_code": "US",
            "telephone_number": "501-205-4570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "JERRY",
        "middle_name": "MARTIN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-04",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "A2009118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "marty@centralargroup.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4702 W Commercial Dr Ste B3",
            "city": "North Little Rock",
            "state": "AR",
            "country_code": "US",
            "postal_code": "721167073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Epoch Health- North Little Rock, PLLC
• Rebecca Eppinette
• Dina Epstein, M.D.
• Joshua Erdkamp
• Brooke Ann Erickson, RDN
• Jose Dan Octoso Escarda, MD
• Virginia K Eschbacher
• Katelyn Etheredge
• Krystal Renee Eubanks
• James Alford Evans-Hammond, LCSW

• Mental Health Counselor in North Little Rock, AR
• Providers in North Little Rock, AR by specialty
• Mental Health Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2021; 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.