MEDICARE: ERICKSON THERAPY SERVICES PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1447196118
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ERICKSON THERAPY SERVICES PLLC

Provider Business Mailing Address
First Line	:	8114 S ALLORA RD
Second Line	:
City	:	CHENEY
State	:	WA
Zip	:	99004-2143
Country	:	US
Telephone Number	:	509-844-2763
Fax Number	:

Provider Business Practice Location Address
First Line	:	8114 S ALLORA RD
Second Line	:
City	:	CHENEY
State	:	WA
Zip	:	99004-2143
Country	:	US
Telephone Number	:	509-844-2763
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ABIGAIL ERICKSON
Credential	:	LICSW
Telephone Number	:	509-844-2763

Provider Enumeration Date	:	04/27/2026
Last Update Date	:	04/27/2026

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