Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jeremy Erickson, MAMFTC

Individual provider Professional Counselor · NPI 1396225504

Jeremy Erickson, MAMFTC is a Mental Health Counselor in Southaven, Mississippi. Practices as a sole proprietor, works from 3 locations and accepts Medicare assignment. Licensed in Arkansas and Mississippi.

Licensed in
AR, MS
In the registry since
2018
Specialties on file
2
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Practice location Address checks out

232 Goodman Rd W Ste 305
Southaven, MS 38671-8004
Phone: (662) 856-9563
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 120 Meghan Ln, Judsonia, AR 72081-9302 — (501) 729-1730
  • 5740 Getwell Rd Ste D, Southaven, MS 38672-6346 — (601) 790-0583

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 2608 (MS)
Professional Counselor Taxonomy 101YP2500X · Licence A1708258 (AR)

Record details

NPI number1396225504
Entity typeIndividual (Type 1)
GenderMale
Credentials MAMFTC
Sole proprietorYes
NPI enumeratedAugust 16, 2018
Last updated in NPPESApril 3, 2024
Certification dateApril 3, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolUNIVERSITY OF TENNESSEE, HSC, COLLEGE OF MEDICINE
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Southaven