Provider Demographics
NPI:1689821761
Name:ECKHOFF-SPECK, KRISTINE (MA, LPCMH)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:
Last Name:ECKHOFF-SPECK
Suffix:
Gender:F
Credentials:MA, LPCMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5010 E ROSA PARKS PL APT 101
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57110-3122
Mailing Address - Country:US
Mailing Address - Phone:605-306-5458
Mailing Address - Fax:605-305-3310
Practice Address - Street 1:5010 E ROSA PARKS PL APT 101
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57110-3122
Practice Address - Country:US
Practice Address - Phone:605-306-5458
Practice Address - Fax:605-305-3310
Is Sole Proprietor?:No
Enumeration Date:2008-08-20
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLPC7020101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health