Provider Demographics
NPI:1144686866
Name:LUNDEEN, ERICA
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:LUNDEEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:
Other - Last Name:LATOUCHE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:2983 WAKAS TRL
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86005-3545
Mailing Address - Country:US
Mailing Address - Phone:603-455-8901
Mailing Address - Fax:
Practice Address - Street 1:611 N LEROUX ST UNIT F
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-3223
Practice Address - Country:US
Practice Address - Phone:928-235-5252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-11
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-15813101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional