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General NPI Number Information
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NPI Number | 1598096281
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Entity Type | Individual
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Provider Name | THOMAS ECKERT
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Gender | Male
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Dates
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Enumeration Date | 01/20/2010
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Last Update Date | 01/20/2010
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Provider Practice Location Address
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Address Line | 23550 HARPER AVE
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48080-1447
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Country | US
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Telephone | 313-580-2093
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Fax |
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Provider Business Mailing Address
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Address Line | 23550 HARPER AVE
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48080-1447
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Country | US
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Telephone | 313-580-2093
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 102L00000X
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Taxonomy Name | Psychoanalyst
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License Number | 6301014122
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6301014122
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 103TA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Psychologist
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License Number | 6301014122
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 103TA0700X
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Taxonomy Name | Adult Development & Aging Psychologist
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License Number | 6301014122
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License Number State | MI
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Taxonomy #5
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | 6301014122
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License Number State | MI
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Taxonomy #6
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 6301014122
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License Number State | MI
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Taxonomy #7
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 6301014122
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License Number State | MI
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Taxonomy #8
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Taxonomy Code | 103TF0000X
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Taxonomy Name | Family Psychologist
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License Number | 6301014122
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License Number State | MI
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Taxonomy #9
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Taxonomy Code | 103TP0814X
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Taxonomy Name | Psychoanalysis Psychologist
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License Number | 6301014122
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License Number State | MI
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Taxonomy #10
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Taxonomy Code | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number | 6301014122
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License Number State | MI
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Taxonomy #11
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 6301014122
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License Number State | MI
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