Provider Demographics
NPI:1154469856
Name:ECKSTEIN, DOUG A (LPC)
Entity Type:Individual
Prefix:
First Name:DOUG
Middle Name:A
Last Name:ECKSTEIN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1652 NW HUGHWOOD CT
Mailing Address - Street 2:
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97471-8844
Mailing Address - Country:US
Mailing Address - Phone:541-673-3985
Mailing Address - Fax:541-673-8060
Practice Address - Street 1:1652 NW HUGHWOOD CT
Practice Address - Street 2:
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97471-8844
Practice Address - Country:US
Practice Address - Phone:541-673-3985
Practice Address - Fax:541-673-8060
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC0681101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional