Provider Demographics
NPI:1821781592
Name:ECHEVERRIA, ERICK FERNANDO (LCSW)
Entity Type:Individual
Prefix:MR
First Name:ERICK
Middle Name:FERNANDO
Last Name:ECHEVERRIA
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2412 CHURCH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-4005
Mailing Address - Country:US
Mailing Address - Phone:855-681-8700
Mailing Address - Fax:
Practice Address - Street 1:3424 KOSSUTH AVE # 1B101
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2489
Practice Address - Country:US
Practice Address - Phone:718-519-3030
Practice Address - Fax:718-519-5036
Is Sole Proprietor?:No
Enumeration Date:2023-05-30
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0845451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical