Healthcare Provider Details

I. General information

NPI: 1427456102
Provider Name (Legal Business Name): ECCOES ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2014
Last Update Date: 12/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 FLOURTOWN RD
PLYMOUTH MEETING PA
19462-1205
US

IV. Provider business mailing address

60 FLOURTOWN RD
PLYMOUTH MEETING PA
19462-1205
US

V. Phone/Fax

Practice location:
  • Phone: 215-450-4306
  • Fax: 610-525-1935
Mailing address:
  • Phone: 215-450-4306
  • Fax: 610-525-1935

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberCW014946
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW014946
License Number StatePA

VIII. Authorized Official

Name: WILLIAM J GARSON
Title or Position: OWNER
Credential: LCSW
Phone: 215-450-4306