JACOB ERICKSON (NPI# 1942673181) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942673181 |
| Entity Type | Individual |
| Full Name | JACOB ERICKSON |
| Credential | MT-BC |
| Practice Address |
4220 N Grand Blvd Saint Louis MO 63107-1831 |
| Practice Telephone | 3145346624 |
| Enumeration Date | 2015-11-10 |
| Last Update Date | 2015-11-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386282242 | Jacob Erickson | Physical Therapist | 21525 Hwy 410 E Ste B, Bonney Lake, WA 98391-4101 | 2019-12-11 |
| 1700370749 | Jacob Erickson | Optometrist | 2610 Bridge Ave, Albert Lea, MN 56007-2075 | 2018-06-21 |
| 1013352913 | Jacob Erickson | Pain Medicine | 5282 Medical Dr, San Antonio, TX 78229-4849 | 2013-05-06 |
| 1861787814 | Jacob L Erickson | Family Medicine | 191 Theater Rd, Onalaska, WI 54650 | 2011-06-17 |
| 1194059543 | Jacob Neil Erickson | Emergency Medicine | 1200 S Cedar Crest Blvd, Allentown, PA 18103-6202 | 2009-10-01 |
| Street Address |
4220 N GRAND BLVD |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63107-1831 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891101861 | Michael Boland | Counselor | 4220 N Grand Blvd, Saint Louis, MO 63107-1831 | 2014-07-10 |
| 1750902011 | Monica Lynnette White | Counselor | 4220 N Grand Blvd, Saint Louis, MO 63107-1831 | 2020-04-28 |
| 1154941912 | William Briggs | Counselor | 4220 N Grand Blvd, Saint Louis, MO 63107-1831 | 2020-04-22 |
| 1265067094 | Alicia Camille Anderson | Counselor | 4220 N Grand Blvd, Saint Louis, MO 63107-1831 | 2020-03-12 |
| 1841820057 | Herice Vereen | Counselor | 4220 N Grand Blvd, Saint Louis, MO 63107-1831 | 2020-01-16 |
| 1205394897 | Lee Farhat | Registered Nurse | 4220 N Grand Blvd, Saint Louis, MO 63107-1831 | 2019-03-04 |
| 1487140109 | Lola Ann Gunn | Counselor | 4220 N Grand Blvd, Saint Louis, MO 63107-1831 | 2018-07-05 |
| 1366941619 | Phil Hotop | Counselor | 4220 N Grand Blvd, Saint Louis, MO 63107-1831 | 2018-02-01 |
| 1417465964 | Audrey Jane Manners | Counselor | 4220 N Grand Blvd, Saint Louis, MO 63107-1831 | 2018-01-18 |
| 1972018463 | Mary Drummond | Counselor | 4220 N Grand Blvd, Saint Louis, MO 63107-1831 | 2017-12-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851937676 | Elizabeth Lawton | Counselor | Elizabeth Lawton, 4220 North Grand Boulevard, Saint Louis, MO 63107 | 2019-11-27 |
| 1518486885 | Sunflower Podiatry and Wellness | Podiatrist | 1316 Hebert Street, Saint Louis, MO 63107 | 2017-09-18 |
| 1609328996 | Gina Lagarce | Contractor | 801 N. 11th Street, St. Louis Public Schools, Saint Louis, MO 63107 | 2016-11-02 |
| 1932515012 | Christopher L Adams | Counselor | 4220 North Grand Blvd, St.louis, MO 63107 | 2014-07-09 |
| 1902212160 | Nora Ann Boland II | Counselor | 4220 North Grand Blvd., St. Louis, MO 63107 | 2014-07-09 |
| 1700209467 | Calvin Garner | Social Worker | 7018 Destrehan, St Louis, MO 63107 | 2014-01-30 |
| 1225464001 | Spring Manor LLC | Assisted Living Facility | 3610 Palm St., Apt/suite, Saint Louis, MO 63107 | 2013-09-24 |
| 1518189141 | Excel Home Health Care | Chore Provider | 2125 Bissell St, St. Louis, MO 63107 | 2007-05-03 |
| 1407375314 | Shayla Dana Smith | Counselor | 4220 Grand Ave, St Louis, MO 63107 | 2017-09-12 |
| 1528468147 | Annette Michelle Cook | Counselor | 4218 North Grand Blvd, St. Louis, MO 63107 | 2014-09-02 |
| Find all providers in zip 63107 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235736588 | Roberta Kerosevic | Counselor | 12203 Big Bend Rd Ste 101, Saint Louis, MO 63122-6848 | 2020-10-08 |
| 1528665726 | Kimberly Cappetta | Counselor | 4567 W Pine Blvd Apt 710, Saint Louis, MO 63108-2192 | 2020-10-01 |
| 1508475534 | Elizabeth (lisa) Pullen Will-smith | Counselor | 6649 Hoffman Ave, Saint Louis, MO 63139-2546 | 2020-07-27 |
| 1689297970 | Joy Montrice Camp | Counselor | 1126 N 16th St, Saint Louis, MO 63106-3736 | 2020-05-21 |
| 1568084622 | Amy Turk | Counselor | 701 Luckystone Ave, Saint Louis, MO 63122-3245 | 2020-05-12 |
| 1588285647 | Jesse Sieger-walls | Counselor | 32 Bellerive Acres, Saint Louis, MO 63121-4321 | 2020-04-29 |
| 1265061394 | Victoria Kyles | Counselor | 124 Forestwood Dr, Saint Louis, MO 63135-2827 | 2020-04-01 |
| 1790312528 | Sarah Williford | Counselor | 8420 Delmar Blvd Ste 301, Saint Louis, MO 63124-2178 | 2020-03-23 |
| 1033745005 | Casey Robert Thompson | Counselor | 600 Buckley Rd, Saint Louis, MO 63125-5303 | 2020-03-20 |
| 1891328613 | Jessica Kay Dowling | Counselor | 3008 Sutton Blvd Ste 200, Saint Louis, MO 63143-3064 | 2020-02-20 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63107 |
Please comment or provide details below to improve the information on JACOB ERICKSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.