Jaime Coulson Eckrich, LCAC

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Fairway, KS

NPI 1346929338 · NPPES record last updated Jul 17, 2023

Key facts

NPI
1346929338
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
469 (KS)
Practice address
3831 W 57TH Ter
Fairway, KS 66205-3402
Phone
(913) 484-9011
NPI assigned
Jul 17, 2023
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
469KSMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 469 KS Yes

Addresses

Primary practice location

3831 W 57TH Ter
Fairway, KS 66205-3402

Mailing address

3831 W 57TH Ter
Fairway, KS 66205-3402
Phone (913) 484-9011

Other providers in Fairway, KS

All providers in Fairway, KS · Addiction (Substance Use Disorder) Counselor in Kansas

Sources for this page

Verify at the official NPI Registry.