Theodore Eckerle, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34000581A Issued in IN

Practice address

920 West Executive Court
Monticello, IN 47960

Phone

(574) 583-9350

Fax

(574) 583-7997

NPI assigned

May 19, 2014

Last updated

May 19, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Loyola University of Chicago, Stritch School of Medicine, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Valley Oaks Health IncGroup PAC ID 7315927563, 45 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Valley Oaks Health Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lafayette, IN
  • NPI 1689629990
  Medicare reassignment Care Compare group NPD
• Valley Oaks Health Inc

  • Federally Qualified Health Center (FQHC)
  • Lafayette, IN
  • NPI 1134901135
  NPD

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

{
    "created_epoch": "1400457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400457600000",
    "number": "1588075949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 N 26TH ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042895",
            "telephone_number": "574-583-9350",
            "fax_number": "574-583-7997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 WEST EXECUTIVE COURT",
            "city": "MONTICELLO",
            "state": "IN",
            "postal_code": "47960",
            "telephone_number": "574-583-9350",
            "fax_number": "574-583-7997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECKERLE",
        "first_name": "THEODORE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-19",
        "last_updated": "2014-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34000581A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Dobbins
• Elizabeth Ann Droege, M.D.
• Renato M Durham, M.D.
• Peter Harry Dyer, D.C.
• Kim Weber Eckerle, DEVELOPMENTAL THERAP
• Gayle A Edgerly
• James R F Elliott, MA
• Family Rootz LLC
• Linda Jean Feuquay, NCACI ICACII
• Laura Flanigan, PHARMD

• Clinical Social Worker in Monticello, IN
• Providers in Monticello, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.