Provider Demographics
NPI:1982696902
Name:EEKHOFF, JOANNE GALE (LISW)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:GALE
Last Name:EEKHOFF
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4822
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87196-4822
Mailing Address - Country:US
Mailing Address - Phone:505-417-5544
Mailing Address - Fax:505-256-4188
Practice Address - Street 1:7521 SANTIAGO RD SW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87105-7240
Practice Address - Country:US
Practice Address - Phone:505-417-5544
Practice Address - Fax:505-256-4188
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-16
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI-4030104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM101729Medicaid
NMT9622Medicaid