Individual provider Active NPI

Todd Eckert, LCSW

  • Clinical Social Worker
  • Ridgewood, NJ
National Provider Identifier
1093160996
Registry record updated Aug 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05676600 Issued in NJ
Practice address
201 E Ridgewood Ave Ste 5
Ridgewood, NJ 07450-3825
Phone
(201) 394-7777
Fax
(201) 584-0218
NPI assigned
Apr 28, 2016
Last updated
Aug 14, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC05676600 NJ Primary

Addresses

Primary practice location

201 E Ridgewood Ave Ste 5
Ridgewood, NJ 07450-3825

Mailing address

61 Fairview Ave
Glen Rock, NJ 07452-2511
Phone (201) 394-7777

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

LicenseStateTypeSpecialty
44SC05676600NJMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1461801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502668800000",
    "number": "1093160996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 FAIRVIEW AVE",
            "city": "GLEN ROCK",
            "state": "NJ",
            "postal_code": "074522511",
            "telephone_number": "201-394-7777",
            "fax_number": "201-584-0218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E RIDGEWOOD AVE STE 5",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503825",
            "telephone_number": "201-394-7777",
            "fax_number": "201-584-0218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECKERT",
        "first_name": "TODD",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-28",
        "last_updated": "2017-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05676600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.