Provider Demographics
NPI:1962594440
Name:ECKRICH, JEANNE E (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JEANNE
Middle Name:E
Last Name:ECKRICH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 ROWAYTON AVE
Mailing Address - Street 2:
Mailing Address - City:ROWAYTON
Mailing Address - State:CT
Mailing Address - Zip Code:06853
Mailing Address - Country:US
Mailing Address - Phone:203-854-0880
Mailing Address - Fax:203-655-2689
Practice Address - Street 1:149 ROWAYTON AVE
Practice Address - Street 2:
Practice Address - City:ROWAYTON
Practice Address - State:CT
Practice Address - Zip Code:06853
Practice Address - Country:US
Practice Address - Phone:203-854-0880
Practice Address - Fax:203-655-2689
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0020791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical