Provider Demographics
NPI:1437439114
Name:ECKHARDT, JULIE (LMHC)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:ECKHARDT
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17772 OAKMONT RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33967-5294
Mailing Address - Country:US
Mailing Address - Phone:888-428-2788
Mailing Address - Fax:
Practice Address - Street 1:18581 SARASOTA RD
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33967-3520
Practice Address - Country:US
Practice Address - Phone:239-217-1055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-25
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 10364101YM0800X
FLMH10364102L00000X, 106E00000X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst