Provider Demographics
NPI:1952723348
Name:FLICKER, ERIN JESSICA (MSW LICSW)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:JESSICA
Last Name:FLICKER
Suffix:
Gender:F
Credentials:MSW LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 OTTAWA AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55107-2559
Mailing Address - Country:US
Mailing Address - Phone:651-331-8868
Mailing Address - Fax:
Practice Address - Street 1:3011 36TH AVE S STE 6
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55406-2800
Practice Address - Country:US
Practice Address - Phone:651-331-8868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-20
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN180691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical