Provider Demographics
NPI:1104361989
Name:ERICKSON, CHAD (LMHC)
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:
Last Name:ERICKSON
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 W PACIFIC AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-4320
Mailing Address - Country:US
Mailing Address - Phone:509-474-9984
Mailing Address - Fax:
Practice Address - Street 1:304 W PACIFIC AVE STE 210
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-4320
Practice Address - Country:US
Practice Address - Phone:509-474-9984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-03
Last Update Date:2020-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health