Provider Demographics
NPI:1093045916
Name:ERICKSON, CHRISTINE D (NCC, LMHC)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:D
Last Name:ERICKSON
Suffix:
Gender:F
Credentials:NCC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1435 31ST ST NE STE B
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-4056
Mailing Address - Country:US
Mailing Address - Phone:319-200-5006
Mailing Address - Fax:
Practice Address - Street 1:1435 31ST ST NE STE B
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-4056
Practice Address - Country:US
Practice Address - Phone:319-200-5006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-29
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001574101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional