Provider Demographics
NPI:1245401256
Name:ERICKSON, PAULETTE LEEANNE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:PAULETTE
Middle Name:LEEANNE
Last Name:ERICKSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:PAULETTE
Other - Middle Name:LEEANNE
Other - Last Name:ENGLAND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:745 POPLAR AVE
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-1066
Mailing Address - Country:US
Mailing Address - Phone:303-868-0082
Mailing Address - Fax:
Practice Address - Street 1:745 POPLAR AVE
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-1066
Practice Address - Country:US
Practice Address - Phone:303-868-0082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-18
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical