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NPI Code Detail

MEDICARE: ECLECTIC THERAPEUTIC CONNECTIONS INC

MEDICARE: ECLECTIC THERAPEUTIC CONNECTIONS INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency1298943NC

General Provider Information

NPI Number : 1073957775
Entity Type Code : Organization
Provider Name (Legal Business Name) : ECLECTIC THERAPEUTIC CONNECTIONS INC
Provider Business Mailing Address
First Line : 3605 TEMPIA CT
Second Line :
City : RALEIGH
State : NC
Zip : 27610-4291
Country : US
Telephone Number : 919-637-4089
Fax Number : 888-462-2058
Provider Business Practice Location Address
First Line : 8601 SIX FORKS RD STE 400
Second Line : FORUM I
City : RALEIGH
State : NC
Zip : 27615-2965
Country : US
Telephone Number : 919-637-4089
Fax Number : 888-462-2058
Authorized Official
Title or Position : CEO
Name : TANIELLE LOVEVET ARLEDGE BROWN
Credential : LPC
Telephone Number : 919-637-4089
Provider Enumeration Date : 04/24/2013
Last Update Date : 10/14/2024

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Directions to “ECLECTIC THERAPEUTIC CONNECTIONS INC ” Practice Location

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