Provider Demographics
NPI:1598202640
Name:ECKHOFF, MICHELLE LOUISE (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:LOUISE
Last Name:ECKHOFF
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 SHERBROOKE DR
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-4704
Mailing Address - Country:US
Mailing Address - Phone:718-510-2170
Mailing Address - Fax:
Practice Address - Street 1:46 SHERBROOKE DR
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-4704
Practice Address - Country:US
Practice Address - Phone:718-510-2170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-27
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3291106H00000X
NY001429106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist