Provider Demographics
NPI:1720298557
Name:ERICKSON, STEVEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:ERICKSON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1177 QUEEN ST
Mailing Address - Street 2:2006
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-4138
Mailing Address - Country:US
Mailing Address - Phone:808-783-7774
Mailing Address - Fax:
Practice Address - Street 1:1928 WAIOLA ST APT C
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-2605
Practice Address - Country:US
Practice Address - Phone:808-783-7774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI795103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical