Provider Demographics
NPI:1881106771
Name:BUDSON, ERIKA LYNN (LPC)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:LYNN
Last Name:BUDSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22811 GREATER MACK AVE STE L2
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48080-2057
Mailing Address - Country:US
Mailing Address - Phone:586-355-2006
Mailing Address - Fax:586-279-3886
Practice Address - Street 1:22811 GREATER MACK AVE STE L2
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48080-2057
Practice Address - Country:US
Practice Address - Phone:586-355-2006
Practice Address - Fax:586-279-3886
Is Sole Proprietor?:No
Enumeration Date:2017-10-31
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401014558101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6401014558OtherSTATE OF MICHIGAN - PROFESSIONAL COUNSELOR LICENSE