| Tracy Eckert Llc | |
|
50 Albany Tpke Suite 5036 Canton CT 06019-2516 | |
| (860) 965-7500 | |
| (410) 861-6262 |
| Full Name | Tracy Eckert Llc |
|---|---|
| Speciality | Counselor |
| Location | 50 Albany Tpke, Canton, Connecticut |
| Authorized Official Name and Position | Tracy Mills Eckert (OWNER) |
| Authorized Official Contact | 8609657500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tracy Eckert Llc 22 Camille Ln Canton CT 06019-2040 Ph: (860) 965-7500 | Tracy Eckert Llc 50 Albany Tpke Suite 5036 Canton CT 06019-2516 Ph: (860) 965-7500 |
| NPI Number | 1578792826 |
|---|---|
| Provider Enumeration Date | 07/08/2009 |
| Last Update Date | 07/08/2009 |
| Medicare PECOS PAC ID | 3779928288 |
|---|---|
| Medicare Enrollment ID | O20240223002638 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578792826 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Tracy Mills Eckert |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154476927 PECOS PAC ID: 4688019193 Enrollment ID: I20240223002644 |
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