Provider Demographics
NPI:1396387346
Name:ERICKSON, CATHERINE (LICSW)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:ERICKSON
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60187
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98160-0187
Mailing Address - Country:US
Mailing Address - Phone:206-546-3049
Mailing Address - Fax:
Practice Address - Street 1:6527 - 21ST AVE NE
Practice Address - Street 2:SUITE 4
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115
Practice Address - Country:US
Practice Address - Phone:206-546-3049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-10
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000078761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WALW00007876OtherLICENSED CLINICAL SOCIAL WORKER