1811772866 NPI number — MARIA ERICKSON COUNSELING AND LIFE SOLUTIONS

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811772866 NPI number — MARIA ERICKSON COUNSELING AND LIFE SOLUTIONS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MARIA ERICKSON COUNSELING AND LIFE SOLUTIONS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1811772866
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/29/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11882 91ST TER
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SEMINOLE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33772-2744
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-744-2077
Provider Business Mailing Address Fax Number:
727-343-7783

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11882 91ST TER
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SEMINOLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33772-2744
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-744-2077
Provider Business Practice Location Address Fax Number:
727-343-7783
Provider Enumeration Date:
08/29/2023

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ERICKSON
Authorized Official First Name:
MARIA
Authorized Official Middle Name:
M
Authorized Official Title or Position:
COUNSELOR AND OWNER
Authorized Official Telephone Number:
727-744-2077

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)