Provider Demographics
NPI:1861172884
Name:ERICKSON, EMILY CORCORAN (MSW, LICSW)
Entity type:Individual
Prefix:MS
First Name:EMILY
Middle Name:CORCORAN
Last Name:ERICKSON
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5448 43RD AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55417-2236
Mailing Address - Country:US
Mailing Address - Phone:612-590-4229
Mailing Address - Fax:
Practice Address - Street 1:6636 CEDAR AVE S STE 360
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55423-2712
Practice Address - Country:US
Practice Address - Phone:612-268-5858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-24
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN281571041C0700X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical