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NPI Code Detail

MEDICARE: PAULA ECKARDT LCSW-R

MEDICARE: PAULA ECKARDT LCSW-R
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
1101YM0800XMental Health CounselorR041057-1NY

General Provider Information

NPI Number : 1649322959
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAULA ECKARDT LCSW-R
Provider Business Mailing Address
First Line : 1641 3RD ST
Second Line :
City : RENSSELAER
State : NY
Zip : 12144-1539
Country : US
Telephone Number : 518-463-8869
Fax Number : 518-463-8733
Provider Business Practice Location Address
First Line : 1641 3RD ST
Second Line :
City : RENSSELAER
State : NY
Zip : 12144-1539
Country : US
Telephone Number : 518-463-8869
Fax Number : 518-463-8733
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2007
Last Update Date : 07/08/2007

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Directions to “ PAULA ECKARDT LCSW-R” Practice Location

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