Provider Demographics
NPI:1417019340
Name:PICKERING, ERIC B (PHD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:B
Last Name:PICKERING
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 PIEDMONT RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3814
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3620 N HIGH ST
Practice Address - Street 2:STE 107
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3611
Practice Address - Country:US
Practice Address - Phone:614-263-8161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6136103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical