Provider Demographics
NPI:1982952412
Name:ERICKSON, ANDREW BRUCE (MSW, LCSW)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:BRUCE
Last Name:ERICKSON
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1555 S LAYTON BLVD
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53215-1924
Mailing Address - Country:US
Mailing Address - Phone:414-385-6600
Mailing Address - Fax:
Practice Address - Street 1:1555 S LAYTON BLVD
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53215-1924
Practice Address - Country:US
Practice Address - Phone:414-385-6600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-15
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7687-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical