Provider Demographics
NPI:1518348614
Name:ERRICKSON, NICOLE (LCSW)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:ERRICKSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 S THORNTON AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30720-8268
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:302 S THORNTON AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-8268
Practice Address - Country:US
Practice Address - Phone:706-529-5980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-15
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical