Provider Demographics
NPI:1932824240
Name:ERICKSON, SARAH KRISTINA (LMSW)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:KRISTINA
Last Name:ERICKSON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1363 W SUNRISE RIM RD
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83705-5129
Mailing Address - Country:US
Mailing Address - Phone:208-451-3050
Mailing Address - Fax:
Practice Address - Street 1:175 E 50TH ST
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:ID
Practice Address - Zip Code:83714-1413
Practice Address - Country:US
Practice Address - Phone:208-451-3050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-10
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLMSW-42707101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health