Healthcare Provider Details

I. General information

NPI: 1871003681
Provider Name (Legal Business Name): PETER ERICKSON COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2017
Last Update Date: 09/07/2023
Certification Date: 09/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

931 BELLVIEW AVE
ASHLAND OR
97520-3603
US

IV. Provider business mailing address

931 BELLVIEW AVE
ASHLAND OR
97520-3603
US

V. Phone/Fax

Practice location:
  • Phone: 541-238-5135
  • Fax: 541-273-6279
Mailing address:
  • Phone: 541-238-5135
  • Fax: 541-273-6279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License NumberC3681
License Number StateOR

VIII. Authorized Official

Name: MRS. DAWN LYNNETTE JONES
Title or Position: MEDICAL BILLING SPECIALIST/CPC
Credential: BS, CPC
Phone: 541-883-7798