Provider Demographics
NPI:1669027892
Name:ECKHOLDT, CAMERON J (PLPC)
Entity Type:Individual
Prefix:MR
First Name:CAMERON
Middle Name:J
Last Name:ECKHOLDT
Suffix:
Gender:M
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2321 N HULLEN ST STE B
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-6917
Mailing Address - Country:US
Mailing Address - Phone:504-941-7580
Mailing Address - Fax:504-941-7585
Practice Address - Street 1:2321 N HULLEN ST STE B
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-6917
Practice Address - Country:US
Practice Address - Phone:504-941-7580
Practice Address - Fax:504-941-7585
Is Sole Proprietor?:No
Enumeration Date:2019-08-05
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7790171M00000X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No171M00000XOther Service ProvidersCase Manager/Care Coordinator