Erickson, Susane

Erickson, Susane is an individual health care provider with primary practice located at 3910 Lewis Speedway Ste 1103 , Saint Augustine FL 32084-8649. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Erickson, Susane can be contacted via phone (904) 829-2273.

Contact Information

Primary practice address
3910 Lewis Speedway Ste 1103 Saint Augustine FL 32084-8649
Phone: (904) 829-2273
Fax: (904) 824-0724
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X MH7654 Florida
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 7654 Florida
Behavioral Health & Social Service Providers / Professional 101YP2500X 2000 West Virginia

Profile Details

NPI number 1629067004
LBN Legal business name Erickson, Susane
Credentials LMHC
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2005
Last updated Apr 9th, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629067004 NPPES
Florida MEDICAID 766307200
Florida Other Z086G

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