Provider Demographics
NPI:1184749202
Name:ECKERT, NICHOLE ELIZABETH (MS, LMHC)
Entity type:Individual
Prefix:MS
First Name:NICHOLE
Middle Name:ELIZABETH
Last Name:ECKERT
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19672 E COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-2552
Mailing Address - Country:US
Mailing Address - Phone:305-527-5220
Mailing Address - Fax:
Practice Address - Street 1:19022 NE 29TH AVE
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-2823
Practice Address - Country:US
Practice Address - Phone:305-936-1002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 8637101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health