Provider Demographics
NPI:1902312986
Name:ERICKSON, WHITNEY (LICSW)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:ERICKSON
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34610 11TH CT SW
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-7046
Mailing Address - Country:US
Mailing Address - Phone:801-318-4525
Mailing Address - Fax:
Practice Address - Street 1:34610 11TH CT SW
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98023-7046
Practice Address - Country:US
Practice Address - Phone:801-318-4525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-28
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9480092-35011041C0700X
WALW610338141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical