Healthcare Provider Details

I. General information

NPI: 1245696319
Provider Name (Legal Business Name): ERIKA HENDIERCKS M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2016
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 SAN REMO DR
SOUTH BURLINGTON VT
05403-6312
US

IV. Provider business mailing address

45 SAN REMO DR
SOUTH BURLINGTON VT
05403-6312
US

V. Phone/Fax

Practice location:
  • Phone: 802-951-0450
  • Fax:
Mailing address:
  • Phone: 802-734-1265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number068.0116701
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: