Healthcare Provider Details

I. General information

NPI: 1619141512
Provider Name (Legal Business Name): DAVID A ERRICKSON LCSW, LCADC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2008
Last Update Date: 05/11/2023
Certification Date: 05/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

194 N HARRISON ST STE 2
PRINCETON NJ
08540-3516
US

IV. Provider business mailing address

1308 ROUTE 31 N
ANNANDALE NJ
08801-3119
US

V. Phone/Fax

Practice location:
  • Phone: 908-892-2217
  • Fax:
Mailing address:
  • Phone: 908-892-2217
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number37LC00089100
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC04685700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: