Healthcare Provider Details

I. General information

NPI: 1740774652
Provider Name (Legal Business Name): CARY ANNE ECKARD LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2018
Last Update Date: 08/09/2024
Certification Date: 08/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16761 SAINT CLAIR AVE STE 2
EAST LIVERPOOL OH
43920-9400
US

IV. Provider business mailing address

16761 SAINT CLAIR AVE STE 2
EAST LIVERPOOL OH
43920-9400
US

V. Phone/Fax

Practice location:
  • Phone: 330-932-1823
  • Fax: 330-932-1832
Mailing address:
  • Phone: 330-932-1823
  • Fax: 330-932-1832

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE.2404536
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: