Individual
MR. CLARK J ERICKSON
Active
Individual
MR. CLARK J ERICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1964
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
143648
UCARE
MN
01
—
41-1576550
BHP
MN
01
—
504S6ER
BCBS
FM
01
—
62-60891
UBH
MN
01
—
901783600
MN CARE
MN
01
—
HP37280
HEALTHPARTNERS
MN
Enumeration date
10/10/2006
Last updated
02/02/2009
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