Healthcare Provider Details

I. General information

NPI: 1699865477
Provider Name (Legal Business Name): CHRISTOPHER ERSKINE MSW,LISCW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 01/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 LOWER MAIN ST. WEST
JOHNSON VT
05656
US

IV. Provider business mailing address

2316 W HILL RD
CRAFTSBURY VT
05826-9551
US

V. Phone/Fax

Practice location:
  • Phone: 802-635-8900
  • Fax:
Mailing address:
  • Phone: 802-586-9932
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number089-0000536
License Number StateVT

VII. Legacy identifiers

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

# 1
Identifier00029523
Identifier TypeOTHER
Identifier StateVT
Identifier IssuerBCBS
# 2
Identifier1009565
Identifier TypeMEDICAID
Identifier StateVT
Identifier Issuer
# 3
Identifier2154137
Identifier TypeOTHER
Identifier StateVT
Identifier IssuerCIGNA
# 4
Identifier39496
Identifier TypeOTHER
Identifier StateVT
Identifier IssuerMVP

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: