Active NPI
Kristen Ecklund, LPC
- Professional Counselor
- Chatham, NJ
National Provider Identifier
1013393073
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 37PC00786800
- Practice address
- 165 Riveredge Dr
Chatham, NJ 07928-3114 - Phone
- (646) 338-9921
- NPI assigned
- Jul 31, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 37PC00786800 | NJ | Primary |
Addresses
Primary practice location
165 Riveredge Dr
Chatham, NJ 07928-3114
Mailing address
165 Riveredge Dr
Chatham, NJ 07928-3114
Phone (646) 338-9921
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37PC00786800 | NJ | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639094400000",
"number": "1013393073",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "165 RIVEREDGE DR",
"city": "CHATHAM",
"state": "NJ",
"postal_code": "079283114",
"telephone_number": "646-338-9921"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "165 RIVEREDGE DR",
"city": "CHATHAM",
"state": "NJ",
"postal_code": "079283114",
"telephone_number": "646-338-9921"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ECKLUND",
"first_name": "KRISTEN",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-31",
"last_updated": "2021-12-10",
"certification_date": "2021-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NJ",
"license": "37PC00786800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chatham, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.