Provider Demographics
NPI:1093160996
Name:ECKERT, TODD (LCSW)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:
Last Name:ECKERT
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:GLEN ROCK
Mailing Address - State:NJ
Mailing Address - Zip Code:07452-2511
Mailing Address - Country:US
Mailing Address - Phone:201-394-7777
Mailing Address - Fax:201-584-0218
Practice Address - Street 1:201 E RIDGEWOOD AVE STE 5
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-3825
Practice Address - Country:US
Practice Address - Phone:201-394-7777
Practice Address - Fax:201-584-0218
Is Sole Proprietor?:No
Enumeration Date:2016-04-28
Last Update Date:2017-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC056766001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical