Provider Demographics
NPI:1295050581
Name:ECKLEY, MATTHEW D (LCSW)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:D
Last Name:ECKLEY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 LOVEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:WARRIORS MARK
Mailing Address - State:PA
Mailing Address - Zip Code:16877-6713
Mailing Address - Country:US
Mailing Address - Phone:814-404-8695
Mailing Address - Fax:
Practice Address - Street 1:755 LOVEVILLE RD
Practice Address - Street 2:
Practice Address - City:WARRIORS MARK
Practice Address - State:PA
Practice Address - Zip Code:16877-6713
Practice Address - Country:US
Practice Address - Phone:814-404-8695
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-30
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0172191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical