Robert Ericson, Phd

LBN: Robert Ericson, Phd
Robert Ericson, Phd is an health care organization with primary practice located at 6463 4Th St Nw Suite C, Los Ranchos De Albuquerque NM 87107-5810. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Cognitive & Behavioral, which is considered as the primary health care specialty. Robert Ericson, Phd can be contacted via phone (505) 344-9500, or through Ericson, Robert Charles via phone (505) 242-6672.

Contact Information

Primary practice address
6463 4Th St Nw Suite C Los Ranchos De Albuquerque NM 87107-5810
Phone: (505) 344-9500
Fax: (505) 342-1084
Website:
Map and Directions
Authorized official contact:
Name: Ericson, Robert Charles PHD
Phone: (505) 242-6672

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Cognitive & Behavioral 103TB0200X 239 New Mexico

Profile Details

NPI number 1700069796
LBN Legal business name Robert Ericson, Phd
DBA Doing business as
Authorized official Ericson, Robert Charles PHD
Entity Organization
Organization subpart 1 No
Enumeration date Dec 12th, 2007
Last updated Aug 5th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700069796 NPPES
New Mexico Other NM00N206 BLUE CROSS BLUE SHIELD
New Mexico MEDICAID N8396 BLUE CROSS BLUE SHIELD

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