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NPI Code Detail

MEDICARE: MR. CHARLES S ECKELT SR. LPC, NCC

MEDICARE: MR. CHARLES S ECKELT SR. LPC, NCC
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
1101YP2500XProfessional Counselor1547OK

General Provider Information

NPI Number : 1841375821
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CHARLES S ECKELT SR. LPC, NCC
Provider Business Mailing Address
First Line : 3539 S TOLEDO AVE
Second Line :
City : TULSA
State : OK
Zip : 74135-1728
Country : US
Telephone Number : 918-749-5343
Fax Number : 918-749-5343
Provider Business Practice Location Address
First Line : 6440 S LEWIS AVE STE 2200
Second Line :
City : TULSA
State : OK
Zip : 74136-1060
Country : US
Telephone Number : 918-712-0859
Fax Number : 918-388-6456
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2006
Last Update Date : 06/18/2025

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