Provider Demographics
NPI:1033645064
Name:ECKE, KATLIN
Entity Type:Individual
Prefix:
First Name:KATLIN
Middle Name:
Last Name:ECKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATLIN
Other - Middle Name:
Other - Last Name:MACHUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1306 MOUNT MISERY RD
Mailing Address - Street 2:
Mailing Address - City:WHITING
Mailing Address - State:NJ
Mailing Address - Zip Code:08759-4103
Mailing Address - Country:US
Mailing Address - Phone:609-312-3322
Mailing Address - Fax:
Practice Address - Street 1:1306 MOUNT MISERY RD
Practice Address - Street 2:
Practice Address - City:WHITING
Practice Address - State:NJ
Practice Address - Zip Code:08759-4103
Practice Address - Country:US
Practice Address - Phone:609-312-3322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC057317001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical