Provider Demographics
NPI:1871003681
Name:PETER ERICKSON COUNSELING
Entity Type:Organization
Organization Name:PETER ERICKSON COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLING SPECIALIST/CPC
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:LYNNETTE
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:BS, CPC
Authorized Official - Phone:541-883-7798
Mailing Address - Street 1:931 BELLVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-3603
Mailing Address - Country:US
Mailing Address - Phone:541-238-5135
Mailing Address - Fax:541-273-6279
Practice Address - Street 1:931 BELLVIEW AVE
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-3603
Practice Address - Country:US
Practice Address - Phone:541-238-5135
Practice Address - Fax:541-273-6279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-06
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
ORC3681261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORC3681OtherLICENSE NUMBER