Provider Demographics
NPI: | 1932270550 |
---|---|
Name: | SETTER, ERICA N (LCSW) |
Entity Type: | Individual |
Prefix: | MS |
First Name: | ERICA |
Middle Name: | N |
Last Name: | SETTER |
Suffix: | |
Gender: | F |
Credentials: | LCSW |
Other - Prefix: | |
Other - First Name: | ERICA |
Other - Middle Name: | L |
Other - Last Name: | NIEMIEC |
Other - Suffix: | |
Other - Last Name Type: | Other Name |
Other - Credentials: | |
Mailing Address - Street 1: | 1843 AUSTIN BLUFFS PKWY |
Mailing Address - Street 2: | |
Mailing Address - City: | COLORADO SPRINGS |
Mailing Address - State: | CO |
Mailing Address - Zip Code: | 80918-7857 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 719-531-5585 |
Mailing Address - Fax: | 719-548-8396 |
Practice Address - Street 1: | 1843 AUSTIN BLUFFS PKWY |
Practice Address - Street 2: | |
Practice Address - City: | COLORADO SPRINGS |
Practice Address - State: | CO |
Practice Address - Zip Code: | 80918-7857 |
Practice Address - Country: | US |
Practice Address - Phone: | 719-531-5585 |
Practice Address - Fax: | 719-548-8396 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-11-13 |
Last Update Date: | 2007-07-08 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CO | 983042 | 103T00000X, 1041C0700X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Not Answered | 103T00000X | Behavioral Health & Social Service Providers | Psychologist | |
Not Answered | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
CO | 076870 | Medicaid |