Provider Demographics
NPI:1376759134
Name:ECREMENT, EUGENE RAYMOND (MA, LPCC-S, IMFT)
Entity Type:Individual
Prefix:MR
First Name:EUGENE
Middle Name:RAYMOND
Last Name:ECREMENT
Suffix:
Gender:M
Credentials:MA, LPCC-S, IMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12322 GARNELL ST NW
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44647-9518
Mailing Address - Country:US
Mailing Address - Phone:330-268-3461
Mailing Address - Fax:
Practice Address - Street 1:3409 JOHNSON RD
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:OH
Practice Address - Zip Code:44203-6201
Practice Address - Country:US
Practice Address - Phone:330-268-3461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE1666101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional