Provider Demographics
NPI:1700775889
Name:WYCKOFF, ERIK PATRICK (MS CMHC PRE-LICENSED)
Entity type:Individual
Prefix:
First Name:ERIK
Middle Name:PATRICK
Last Name:WYCKOFF
Suffix:
Gender:M
Credentials:MS CMHC PRE-LICENSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 KNOWLES ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-1710
Mailing Address - Country:US
Mailing Address - Phone:413-530-5183
Mailing Address - Fax:
Practice Address - Street 1:110 ARMISTICE BLVD
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-5354
Practice Address - Country:US
Practice Address - Phone:774-381-9648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health