Healthcare Provider Details

I. General information

NPI: 1083704969
Provider Name (Legal Business Name): ECKMAN FREEMAN & ASSOC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 02/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3660 WALDEN DR SUITE A
LEXINGTON KY
40517-2021
US

IV. Provider business mailing address

PO BOX 910748 3660 WALDEN DRIVE SUITE A
LEXINGTON KY
40591-0748
US

V. Phone/Fax

Practice location:
  • Phone: 859-273-8107
  • Fax: 859-273-8412
Mailing address:
  • Phone: 859-273-8107
  • Fax: 859-273-8412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number0000
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHARON MARSH
Title or Position: MANAGER
Credential: RN, BSN, CCM
Phone: 859-234-6626