Provider Demographics
NPI:1114986916
Name:MCPHERSON, ERIN PAIGE (MSW, LICSW)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:PAIGE
Last Name:MCPHERSON
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1204 7TH STREET SOUTH
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ST. CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56301
Mailing Address - Country:US
Mailing Address - Phone:320-281-3988
Mailing Address - Fax:320-281-3989
Practice Address - Street 1:1204 7TH STREET SOUTH
Practice Address - Street 2:SUITE 102
Practice Address - City:ST. CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56301
Practice Address - Country:US
Practice Address - Phone:320-281-3988
Practice Address - Fax:320-281-3989
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-21
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN130731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN220G8MCOtherBLUE CROSS INDIV
MN227G0MCOtherBLUE CROSS GROUP
MN114831OtherHEALTH PARTNERS
MN125138400Medicaid
MN62-47529OtherMEDICA
MN227G0MCOtherBLUE CROSS GROUP