Provider Demographics
NPI:1760836480
Name:ECKELKAMP, DAVID (LMHC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:ECKELKAMP
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 RESERVOIR ST
Mailing Address - Street 2:STE. 21
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02494-3149
Mailing Address - Country:US
Mailing Address - Phone:781-449-1143
Mailing Address - Fax:781-449-5992
Practice Address - Street 1:220 RESERVOIR ST
Practice Address - Street 2:STE. 21
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02494-3149
Practice Address - Country:US
Practice Address - Phone:781-449-1143
Practice Address - Fax:781-449-5992
Is Sole Proprietor?:No
Enumeration Date:2016-04-19
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7659101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health