MEDICARE: ERIC JAMES COLECHENG MA, EDS

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
1	103TS0200X	School Psychologist	250260477	CA
2	103TS0200X	School Psychologist	1303716	NC

General Provider Information

NPI Number	:	1154284032
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC JAMES COLECHENG MA, EDS

Provider Business Mailing Address
First Line	:	2524 SILAS PEAK LN
Second Line	:
City	:	APEX
State	:	NC
Zip	:	27523-7176
Country	:	US
Telephone Number	:	805-515-6545
Fax Number	:

Provider Business Practice Location Address
First Line	:	2524 SILAS PEAK LN
Second Line	:
City	:	APEX
State	:	NC
Zip	:	27523-7176
Country	:	US
Telephone Number	:	805-515-6545
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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