Provider Demographics
NPI:1265533400
Name:LAMAR, ERICKA JANETTE (PSYD, LP)
Entity type:Individual
Prefix:
First Name:ERICKA
Middle Name:JANETTE
Last Name:LAMAR
Suffix:
Gender:F
Credentials:PSYD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 EAST THIRD STREET
Mailing Address - Street 2:ESSENTIA HEALTH DULUTH CLINIC MCL2CRED
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55805-1951
Mailing Address - Country:US
Mailing Address - Phone:218-786-8364
Mailing Address - Fax:
Practice Address - Street 1:5211 HIGHWAY 110
Practice Address - Street 2:ESSENTIA HEALTH NORTHERN PINES CLINIC
Practice Address - City:AURORA
Practice Address - State:MN
Practice Address - Zip Code:55705
Practice Address - Country:US
Practice Address - Phone:218-229-3311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2017-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP4434103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN824661100Medicaid
MN824661100Medicaid