MEDICARE: MS. NICHOLE ELIZABETH ECKERT MS, LMHC

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	101YM0800X	Mental Health Counselor	MH 8637	FL

General Provider Information

NPI Number	:	1184749202
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NICHOLE ELIZABETH ECKERT MS, LMHC

Provider Business Mailing Address
First Line	:	19672 E COUNTRY CLUB DR
Second Line	:
City	:	AVENTURA
State	:	FL
Zip	:	33180-2552
Country	:	US
Telephone Number	:	305-527-5220
Fax Number	:

Provider Business Practice Location Address
First Line	:	19022 NE 29TH AVE
Second Line	:
City	:	AVENTURA
State	:	FL
Zip	:	33180-2823
Country	:	US
Telephone Number	:	305-936-1002
Fax Number	:

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

Provider Enumeration Date	:	03/20/2007
Last Update Date	:	07/08/2007

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