Provider Demographics
NPI:1316512064
Name:EREKSON, CAROL DREW
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:DREW
Last Name:EREKSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1921 E STAG HILL CIR
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-8348
Mailing Address - Country:US
Mailing Address - Phone:385-327-3936
Mailing Address - Fax:
Practice Address - Street 1:1921 E STAG HILL CIR
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-8348
Practice Address - Country:US
Practice Address - Phone:385-327-3936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-25
Last Update Date:2025-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13525557-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty