Healthcare Provider Details

I. General information

NPI: 1437987195
Provider Name (Legal Business Name): ERICA NICOLE ABERCROMBIE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2024
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1976 GARDEN AVE
EUGENE OR
97403-1933
US

IV. Provider business mailing address

1976 GARDEN AVE
EUGENE OR
97403-1933
US

V. Phone/Fax

Practice location:
  • Phone: 541-255-1411
  • Fax: 541-255-1412
Mailing address:
  • Phone: 541-255-1411
  • Fax: 541-255-1412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number24-QMHA-R-5680
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberR11636
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: