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Individual
PHILIP R ERICKSON
Active
Individual
PHILIP R ERICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.C.S.W.
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904003523
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107399
ANTHEM
VA
01
—
107400
ANTHEM
VA
01
—
295841
AMERIGROUP
VA
Enumeration date
08/29/2006
Last updated
09/07/2007
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