Provider Demographics
NPI:1952441610
Name:BJORUM, ERICK H (CAC-AD)
Entity Type:Individual
Prefix:MR
First Name:ERICK
Middle Name:H
Last Name:BJORUM
Suffix:
Gender:M
Credentials:CAC-AD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 KINGS ARMS AT WATERFOR
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9148
Mailing Address - Country:US
Mailing Address - Phone:717-840-0459
Mailing Address - Fax:
Practice Address - Street 1:10151 YORK RD
Practice Address - Street 2:SUITE 102
Practice Address - City:COCKEYSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21030-3314
Practice Address - Country:US
Practice Address - Phone:410-887-7671
Practice Address - Fax:410-887-7602
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC0969101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)