Mark Eric Ericson is a Clinical in Phoenix, Arizona. Mark Eric Ericson practices all healthcare services and medical treatments related to Clinical. The NPI Number for Mark Eric Ericson is 1609817386. The last update date is 2007-07-08.
Mark Eric Ericson's current location address is 650 E Indian School Rd, Phoenix, Arizona. You can contact this provider via phone number 6022775551. The mailing address for Mark Eric Ericson is 650 E Indian School Rd, Phoenix, Arizona. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mark Eric Ericson |
|---|---|
| Address | 650 E Indian School Rd, Phoenix, Arizona |
| Phone Number | 6022775551 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | LCSW |
NPI Number Detail
| NPI Number | 1609817386 |
|---|---|
| Provider Enumeration Date | 2006-06-10 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 650 E Indian School Rd |
|---|---|
| City | Phoenix |
| State | Arizona (AZ) |
| Post Code | 850121839 |
| Phone Number | 6022775551 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 2002020181 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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What is the unique 10-digit identification code issued to Mark Eric Ericson by the Centers for Medicare & Medicaid Services?
The Mark Eric Ericson has been assigned the NPI (National Provider Identifier) 1609817386 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you please share the complete physical location address where Mark Eric Ericson's facilities are situated?
The facilities of Mark Eric Ericson are physically located at the following address: 650 E Indian School Rd, Phoenix, AZ, 850121839.
What is Mark Eric Ericson's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Mark Eric Ericson's specialized field of practice is Clinical, and the corresponding taxonomy code that categorizes this area of specialization is 1041C0700X.
On what date did the Mark Eric Ericson receive its 1609817386 assignment from the Centers for Medicare & Medicaid Services?
The Mark Eric Ericson was assigned its 1609817386 by the Centers for Medicare & Medicaid Services on 2006-06-10.
When was the Mark Eric Ericson's information last updated?
The Mark Eric Ericson's information was last updated on 2007-07-08.