Provider Demographics
NPI:1114033701
Name:ECKERMANN, MARILYN S (LMSW-ACP)
Entity Type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:S
Last Name:ECKERMANN
Suffix:
Gender:F
Credentials:LMSW-ACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 S SHEPHERD DR STE 215
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-5354
Mailing Address - Country:US
Mailing Address - Phone:713-522-3669
Mailing Address - Fax:713-522-3012
Practice Address - Street 1:4200 S SHEPHERD DR STE 215
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-5354
Practice Address - Country:US
Practice Address - Phone:713-522-3669
Practice Address - Fax:713-522-3012
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX176831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical