Provider Demographics
NPI:1386765576
Name:ECKER, SUSAN L (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:L
Last Name:ECKER
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11334 BOBCAT RD
Mailing Address - Street 2:
Mailing Address - City:ELMO
Mailing Address - State:MO
Mailing Address - Zip Code:64445-8135
Mailing Address - Country:US
Mailing Address - Phone:660-742-3416
Mailing Address - Fax:660-742-3435
Practice Address - Street 1:2416 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:MO
Practice Address - Zip Code:64468-3624
Practice Address - Country:US
Practice Address - Phone:660-562-2352
Practice Address - Fax:660-562-2933
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20070051361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical