Ericson, Kristin
Ericson, Kristin is an sole proprietor health care provider with primary practice located at 118 Spring St , Port Jefferson NY 11777-1817. She recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as her primary health care specialty. Ericson, Kristin can be contacted via phone (631) 476-0564.Contact Information
Primary practice address
118 Spring St
Port Jefferson NY 11777-1817
Phone: (631) 476-0564
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / School | 1041S0200X | R047177-1 | New York |
Profile Details
| NPI number | 1902110059 |
|---|---|
| LBN Legal business name | Ericson, Kristin |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 31st, 2010 |
| Last updated | Sep 10th, 2010 - about 15 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.
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