# JASON ERICKSON LCP LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689208860
- **Authorized official:** MR. JASON PAUL ERICKSON LCP (OWNER)
- **Authorized official phone:** (620) 481-1311

## Contact information

- **Practice address:** 250 N ROCK RD STE 370, WICHITA, KS 67206-2243
- **Practice address phone:** (620) 481-1311
- **Practice address fax:** (316) 333-7281
- **Mailing address:** 1333 N SPLIT RAIL CT, DERBY, KS 67037-2846
- **Mailing address phone:** (620) 481-1311

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103T00000X | Psychologist | — | NULL | Yes |
| 103T00000X | Psychologist | — | — | Yes |

## Other

- **Enumeration date:** 02/27/2020
- **Last updated:** 02/27/2020