Erickson, Clark J
Erickson, Clark J is an sole proprietor health care provider with primary practice located at 6701 Penn Ave So #301, Resonnce Center, Richfield MN 55423-2093. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Erickson, Clark J can be contacted via phone (612) 861-6129.Contact Information
Primary practice address
6701 Penn Ave So #301, Resonnce Center
Richfield MN 55423-2093
Phone: (612) 861-6129
Fax: (612) 861-7589
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 1964 | Minnesota |
Profile Details
| NPI number | 1316035231 |
|---|---|
| LBN Legal business name | Erickson, Clark J |
| Credentials | LICSW |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 10th, 2006 |
| Last updated | Feb 2nd, 2009 - about 16 years ago |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316035231 | NPPES |
| Minnesota | Other | 41-1576550 | BHP |
| Minnesota | Other | 901783600 | BHP |
| Minnesota | Other | 143648 | BHP |
| Minnesota | Other | HP37280 | BHP |
| Minnesota | Other | 504S6ER | BHP |
| Minnesota | Other | 62-60891 | BHP |
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