Provider Demographics
NPI:1811276538
Name:DICKSON, ERIN (LCSW)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:DICKSON
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 1:2236 SOUTH TEXAS STREET
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY - SALT LAKE
Mailing Address - State:UT
Mailing Address - Zip Code:84109-1720
Mailing Address - Country:US
Mailing Address - Phone:801-201-1480
Mailing Address - Fax:
Practice Address - Street 1:455 EAST 200 SOUTH
Practice Address - Street 2:110
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84111-1720
Practice Address - Country:US
Practice Address - Phone:801-214-0652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-11
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program