Active NPI
Marian Eckhardt, PSYD, LP
- Psychologist
- Crystal, MN
National Provider Identifier
1124244785
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- LP5175
- Practice address
- 8025 34TH PL N
Crystal, MN 55427-1926 - Phone
- (612) 393-7885
- Fax
- (763) 546-8577
- NPI assigned
- Apr 18, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Psychologist | 103T00000X | LP5175 | MN | Primary |
Addresses
Primary practice location
8025 34TH PL N
Crystal, MN 55427-1926
Mailing address
8025 34TH PL N
Crystal, MN 55427-1926
Phone (612) 393-7885
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124244785 | Medicaid | MN | |
| 680002860 | Other | MEDICARE PTAN |
Other names 1
- Ms. Marian Teske
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bachmann and Associates, Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Lake Elmo, MN
- NPI 1144210899
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653350400000",
"number": "1124244785",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8025 34TH PL N",
"city": "CRYSTAL",
"state": "MN",
"postal_code": "554271926",
"telephone_number": "612-393-7885",
"fax_number": "763-546-8577"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8025 34TH PL N",
"city": "CRYSTAL",
"state": "MN",
"postal_code": "554271926",
"telephone_number": "612-393-7885",
"fax_number": "763-546-8577"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ECKHARDT",
"first_name": "MARIAN",
"name_prefix": "Ms.",
"credential": "PSYD, LP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-18",
"last_updated": "2022-05-24",
"certification_date": "2022-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MN",
"license": "LP5175",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1124244785",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "680002860",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MARIAN",
"last_name": "TESKE",
"prefix": "MS.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Crystal, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2022; 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.