Provider Demographics
NPI:1841286275
Name:ECKERT, BARBARA ANN (PSYD)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:ANN
Last Name:ECKERT
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 67255
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-0255
Mailing Address - Country:US
Mailing Address - Phone:402-499-3685
Mailing Address - Fax:402-484-6024
Practice Address - Street 1:2935 PINE LAKE RD
Practice Address - Street 2:SUITE F
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-6009
Practice Address - Country:US
Practice Address - Phone:402-817-0897
Practice Address - Fax:402-817-0901
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-21
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE818103TC0700X
NE1474101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025937500Medicaid
NE348157000OtherMIS# FOR MAGELLAN & MEDIC
NE85284OtherBLUE CROSS ID NUMBER
NE47-0772916OtherTAXPAYER ID