Healthcare Provider Details

I. General information

NPI: 1174002885
Provider Name (Legal Business Name): ERIKA DANIELLE PHILLIPO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2018
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 W B ST BLDG B2
SPRINGFIELD OR
97477-4575
US

IV. Provider business mailing address

1170 PEARL ST
EUGENE OR
97401-3541
US

V. Phone/Fax

Practice location:
  • Phone: 541-423-2633
  • Fax:
Mailing address:
  • Phone: 541-743-4340
  • Fax: 541-743-4369

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: