Provider Demographics
NPI:1629747399
Name:ATKINSON, ERIN NICOLE (LCSW)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:NICOLE
Last Name:ATKINSON
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 1:607 N RICHMAN AVE
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92832-1103
Mailing Address - Country:US
Mailing Address - Phone:714-608-5268
Mailing Address - Fax:
Practice Address - Street 1:607 N RICHMAN AVE
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92832-1103
Practice Address - Country:US
Practice Address - Phone:714-608-5268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-07
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA972851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty