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General NPI Number Information
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NPI Number | 1871919282
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Entity Type | Organization
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Legal Business Name | SYNCHRONICITY COUNSELING SOLUTIONS LLC
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Dates
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Enumeration Date | 03/10/2014
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Last Update Date | 09/26/2023
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Provider Practice Location Address
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Address Line | 2702 MACKLIND AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63139-1406
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Country | US
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Telephone | 314-252-0174
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Fax | 314-219-4591
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Provider Business Mailing Address
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Address Line | 3232 CLIFTON AVE UNIT 5177
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City | SAINT LOUIS
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State | MO
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Zip | 63139-4004
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Country | US
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Telephone | 314-252-0174
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Fax | 314-219-4591
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Authorized Official
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Title or Position | OWNER
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Name | JASON ECCKER
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Credential | MSW LCSW
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Telephone | 314-252-0174
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2014004402
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License Number State | MO
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