Provider Demographics
NPI:1629326780
Name:ERICKSON, HALEY DRAUGHON (LCSW)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:DRAUGHON
Last Name:ERICKSON
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 1:6011 BAHIA DEL MAR BLVD APT 152
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33715-1095
Mailing Address - Country:US
Mailing Address - Phone:727-510-7477
Mailing Address - Fax:
Practice Address - Street 1:1900 9TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33704-4224
Practice Address - Country:US
Practice Address - Phone:727-510-7477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-21
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health