Individual provider Active NPI

Samuel Joseph Eckrich, PH.D.

  • Clinical Child & Adolescent Psychologist
  • Morgantown, WV
National Provider Identifier
1669085379
Registry record updated Jan 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
Practice address
1 Medical Center Dr
Morgantown, WV 26506-1200
Phone
(855) 988-2273
NPI assigned
Aug 24, 2020
Last updated
Jan 28, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X NU Primary
Student in an Organized Health Care Education/Training Program 390200000X MD

Addresses

Primary practice location

1 Medical Center Dr
Morgantown, WV 26506-1200

Mailing address

806 Stiles St
Baltimore, MD 21202-4318
Phone (605) 641-9272

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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

Enrollment IDStateProvider typePAC IDDetails
I20221015000170 WV Practitioner - Clinical Psychologist 7618343682 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia University Medical Corporation CurrentSince Sep 30, 2022 Accepting new patients
West Virginia University Medical Corporation CurrentSince Sep 30, 2022 Accepting new patients

Locations

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

201 Bakers Ridge Rd
Morgantown, WV 26508
Phone (304) 598-4300

930 Chestnut Ridge Rd
Morgantown, WV 26505
Phone (304) 293-5299

Interoperability endpoints

  • Direct secure messaging: seckrich336538@direct.wvuhsdirect.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1598227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674864000000",
    "number": "1669085379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 STILES ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212024318",
            "telephone_number": "605-641-9272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265061200",
            "telephone_number": "855-988-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECKRICH",
        "first_name": "SAMUEL",
        "middle_name": "JOSEPH",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-24",
        "last_updated": "2023-01-28",
        "certification_date": "2023-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MD",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

Verify at the official NPI Registry.