John D Eichenberger, L.M.H.C., C.A.S.A.C.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

006328 Issued in NY

Practice address

625 Cross Keys Office Park
Building 600 Suite 625
Fairport, NY 14450-3508

Phone

(585) 425-2840

Fax

(585) 425-2196

NPI assigned

Oct 27, 2015

Last updated

Oct 27, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1445904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445904000000",
    "number": "1093187288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 CROSS KEYS OFFICE PARK",
            "address_2": "BUILDING 600 SUITE 625",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144503508",
            "telephone_number": "585-425-2840",
            "fax_number": "585-425-2196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 CROSS KEYS OFFICE PARK",
            "address_2": "BUILDING 600 SUITE 625",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144503508",
            "telephone_number": "585-425-2840",
            "fax_number": "585-425-2196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EICHENBERGER",
        "first_name": "JOHN",
        "middle_name": "D",
        "credential": "L.M.H.C., C.A.S.A.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-27",
        "last_updated": "2015-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "17971",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "006328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eckerd Corporation (Rite Aid Pharmacy 10845)
• Benjamin Thomas Eckler
• Joann L Eduardo, NYS LIC SLP
• Gail Edwards, RN
• Kristen Rose Ehmann, MA, CCC-SLP
• Jeffrey Craig Eisenberg, MD
• Alicia M Eisenhart, MACCCSLP
• Lynn Marie Ekstrom, RN
• El-Amin-Turner Mental Health Counseling, PLLC
• Shana Eldridge, B.S.

• Mental Health Counselor in Fairport, NY
• Providers in Fairport, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.