Provider Demographics
NPI:1891866091
Name:EICHER, SALLY A (LMSW)
Entity Type:Individual
Prefix:MS
First Name:SALLY
Middle Name:A
Last Name:EICHER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2912 DALEWOOD AVE SE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52403-3033
Mailing Address - Country:US
Mailing Address - Phone:319-364-0524
Mailing Address - Fax:
Practice Address - Street 1:360 7TH AVE
Practice Address - Street 2:STE. 2
Practice Address - City:MARION
Practice Address - State:IA
Practice Address - Zip Code:52302-5771
Practice Address - Country:US
Practice Address - Phone:319-373-9284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA05163101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health