Provider Demographics
NPI:1932277175
Name:ECKHOLT, ALYSON ANDREWS (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:ALYSON
Middle Name:ANDREWS
Last Name:ECKHOLT
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 ASHCROFT CIRCLE
Mailing Address - Street 2:
Mailing Address - City:GROVELAND
Mailing Address - State:MA
Mailing Address - Zip Code:01834
Mailing Address - Country:US
Mailing Address - Phone:978-702-4090
Mailing Address - Fax:
Practice Address - Street 1:77 E MERRIMACK ST
Practice Address - Street 2:SOUTH BAY MENTAL HEALTH SUITE 1
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852
Practice Address - Country:US
Practice Address - Phone:978-453-6800
Practice Address - Fax:978-453-1428
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4926101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health