Provider Demographics
NPI:1699232785
Name:ECKHARDT, NICOLE L (LPCC, NCC)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:L
Last Name:ECKHARDT
Suffix:
Gender:
Credentials:LPCC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1134 E. CHAMPLAIN DR.
Mailing Address - Street 2:STE 101 P.M.B. 158
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720
Mailing Address - Country:US
Mailing Address - Phone:559-425-6425
Mailing Address - Fax:855-748-1125
Practice Address - Street 1:1134 E. CHAMPLAIN DR.
Practice Address - Street 2:STE 101 P.M.B. 158
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720
Practice Address - Country:US
Practice Address - Phone:559-425-6425
Practice Address - Fax:855-748-1125
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-25
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALPCC7460101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional