Provider Demographics
NPI:1821083643
Name:ERICKSON, LINDA K (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:K
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 1:2750 BAHIA VISTA ST
Mailing Address - Street 2:SUITE 108
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2600
Mailing Address - Country:US
Mailing Address - Phone:941-951-1500
Mailing Address - Fax:941-952-9400
Practice Address - Street 1:2750 BAHIA VISTA ST
Practice Address - Street 2:SUITE 108
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2600
Practice Address - Country:US
Practice Address - Phone:941-951-1500
Practice Address - Fax:941-952-9400
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW00038281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL26859Medicare ID - Type Unspecified