Provider Demographics
NPI:1861655425
Name:ERICKSON, KARIN ELIZABETH (LCSW)
Entity Type:Individual
Prefix:
First Name:KARIN
Middle Name:ELIZABETH
Last Name:ERICKSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KARIN
Other - Middle Name:
Other - Last Name:ERICKSON DAWES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:964 UWHARRIE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27312-5149
Mailing Address - Country:US
Mailing Address - Phone:828-231-3751
Mailing Address - Fax:
Practice Address - Street 1:964 UWHARRIE RIDGE RD
Practice Address - Street 2:
Practice Address - City:PITTSBORO
Practice Address - State:NC
Practice Address - Zip Code:27312-5149
Practice Address - Country:US
Practice Address - Phone:828-231-3751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-03
Last Update Date:2015-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0060691041C0700X
222Q00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6007028Medicaid
NC6007028Medicaid