Individual provider Active NPI

Antoinette L. Erickson, MSW, LCSW

  • Clinical Social Worker
  • Boulder, CO
National Provider Identifier
1962511691
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
989635 Issued in CO
Practice address
350 Broadway St
Suite 205
Boulder, CO 80305-3343
Phone
(303) 440-4234
Fax
(303) 442-1630
NPI assigned
Aug 29, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 989635 CO Primary

Addresses

Primary practice location

350 Broadway St
Suite 205
Boulder, CO 80305-3343

Mailing address

193 N Cedar Brook Rd
Boulder, CO 80304-0417
Phone (303) 440-4234

Other names 1

  • 'Toni' Erickson Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
989635COMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962511691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "193 N CEDAR BROOK RD",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803040417",
            "telephone_number": "303-440-4234",
            "fax_number": "440-442-1630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 BROADWAY ST",
            "address_2": "SUITE 205",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803053343",
            "telephone_number": "303-440-4234",
            "fax_number": "303-442-1630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "ANTOINETTE",
        "middle_name": "L.",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "989635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "'TONI'",
            "last_name": "ERICKSON",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.