Individual
GREGORY ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1416 W BELMONT AVE, CHICAGO, IL 60657-0939
(773) 799-8966
Mailing address
402 S SILVER SPRINGS RD, CAPE GIRARDEAU, MO 63703-7536
(573) 334-1100
(573) 651-4345
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
2017030894
MO
Other
Enumeration date
09/21/2017
Last updated
09/19/2021
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