Provider Demographics
NPI:1699218826
Name:MAU, ERICA MARIE (MS, LPC, NCC, CCTP)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:MARIE
Last Name:MAU
Suffix:
Gender:F
Credentials:MS, LPC, NCC, CCTP
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:
Other - Last Name:SCHIPPERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, NCC, CCTP
Mailing Address - Street 1:17400 SE 422ND AVE
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:OR
Mailing Address - Zip Code:97055-6729
Mailing Address - Country:US
Mailing Address - Phone:503-705-9379
Mailing Address - Fax:
Practice Address - Street 1:17400 SE 422ND AVE
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:OR
Practice Address - Zip Code:97055-6729
Practice Address - Country:US
Practice Address - Phone:503-705-9379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-20
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC4378101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health