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Susane Erickson , LMHC

Counselor - Professional β€’ Saint Augustine, FL

Active NPI 1629067004 Individual Practitioner Female Practitioner Accepts Medicare assignment
Practice location in NPPES

3910 Lewis Speedway Ste 1103
Saint Augustine, FL 320848649

Call 9048292273 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

3910 Lewis Speedway Ste 1103

Saint Augustine, FL 320848649

Telephone 9048292273
Fax 9048240724
Organization at the Same NPPES Address or Phone
Epic Community Services, Inc. Facility NPI 1104579424

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

CMS Doctors and Clinicians lists 1 group name: Epic Community Services Inc. See the list

Source: CMS Doctors and Clinicians National Downloadable File, release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

Medicare Profile & Education

Source: CMS Doctors and Clinicians National Downloadable File

Graduation Year

1989

Years since graduation

37 years (graduated 1989)

CMS Doctors and Clinicians data list 1989 as the year this clinician finished professional school.

What this does not show: Years since graduation

It is not the number of years in practice, and more years does not mean better care.

Source: CMS Doctors and Clinicians National Downloadable File.

NPI first issued

2005

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Accepts Medicare assignment

CMS data list this clinician as accepting Medicare assignment. This means agreeing to take the Medicare-approved amount as full payment for covered services.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Susane Erickson has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Susane Erickson as eligible to order or refer Medicare Part B clinical laboratory and imaging services and durable medical equipment (DME) for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Saint Augustine and Florida

2 active clinicians are listed under Counselor - Professional with a practice address in Saint Augustine, FL (869 in Florida).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2025-04-09
Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

License # reported to NPPES WV 2000
Counselor - Mental Health

NUCC Taxonomy Code: 101YM0800X

License # reported to NPPES FL MH7654
Counselor - Mental Health

NUCC Taxonomy Code: 101YM0800X

License # reported to NPPES FL 7654
Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Florida Department of Health Medical Quality Assurance.
Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid ID
766307200 (FL)
Other Identifier Bcbs
Z086G (FL)

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - MENTAL HEALTH COUNSELOR

Medicare Enrollment ID

I20250425000490

Enrollment State Jurisdiction

FL

PECOS Control ID

0840716551

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Not Eligible
Power Mobility Devices (PMD) Not Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Medicare Group Practice Enrollments

Source: CMS Doctors and Clinicians National Downloadable File

Epic Community Services Inc

3910 Lewis Speedway, Saint Augustine, FL 320848649

Phone: 90482922734030

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

2 listed
Maryann Del Cid

Nurse Practitioner - Psychiatric/Mental Health

NPI 1497527865
Erika Nyquist , APRN PMHNP-BC

Nurse Practitioner - Psychiatric/Mental Health

NPI 1316624778

APRNPMHNPBC

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

10 Historical Events
πŸ“
Updated Practice Location April 09, 2025

Registered at 3910 LEWIS SPEEDWAY STE 1103, SAINT AUGUSTINE, FL 320848649 (Tel: 9048292273)

πŸ“
Updated Business Mailing Address April 09, 2025

Registered at 3910 LEWIS SPEEDWAY STE 1103, SAINT AUGUSTINE, FL 320848649 (Tel: 9048292273)

πŸ‘€
Provider Name / Credentials Updated April 09, 2025

Recorded as SUSANE ERICKSON, LMHC

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) April 09, 2025

Counselor (license number reported to NPPES: FL MH7654)

βœ…
NPI Profile Active January 24, 2011

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) January 24, 2011

Registered at 448 LEONARD AVE, FAIRMONT, WV 265543843 (Tel: 3043667174)

πŸ“
Business Mailing Address (Initial Record) January 24, 2011

Registered at 301 SCOTT AVE, MORGANTOWN, WV 265088804 (Tel: 3043667174)

πŸ‘€
Provider Name / Credentials (Initial Record) January 24, 2011

Recorded as SUSANE ERICKSON, LPC

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) January 24, 2011

Counselor (license number reported to NPPES: FL 7654)

🟒
Initial NPI Registration & Enumeration October 18, 2005

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1629067004
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 18, 2005
Last Update: April 09, 2025
Sole Proprietor: No

Mailing Address

3910 Lewis Speedway Ste 1103

Saint Augustine, FL 320848649

Phone: 9048292273

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.