Provider Demographics
NPI:1306048178
Name:MACLEOD, ERIC W (PHD, LP)
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:W
Last Name:MACLEOD
Suffix:
Gender:M
Credentials:PHD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 EMMETT ST W
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49017-2963
Mailing Address - Country:US
Mailing Address - Phone:269-965-8866
Mailing Address - Fax:269-965-4773
Practice Address - Street 1:181 EMMETT ST W
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49017-2963
Practice Address - Country:US
Practice Address - Phone:269-965-8866
Practice Address - Fax:269-965-4773
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301015773103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling