Provider Demographics
NPI:1326438037
Name:ERICKSON, PETER (LPC)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:
Last Name:ERICKSON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:931 BELLVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-3603
Mailing Address - Country:US
Mailing Address - Phone:541-238-5135
Mailing Address - Fax:541-273-6279
Practice Address - Street 1:931 BELLVIEW AVE
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-3603
Practice Address - Country:US
Practice Address - Phone:541-238-5135
Practice Address - Fax:541-273-6279
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-02
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC3681101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health