Jonathan Edward Ekhoff, ED.S.
Individual provider Active NPI School Psychologist · Burket, IN
NPI 1811722705 · NPPES record last updated Sep 4, 2024
Key facts
- NPI
- 1811722705
- Entity type
- Individual (NPI type 1)
- Primary specialty
- School Psychologist 103TS0200X
- License
- 1590434 (IN)
- Practice address
- PO Box 8
Burket, IN 46508-0008 - Phone
- (574) 598-2600
- NPI assigned
- Sep 3, 2024
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1590434 | IN | MD | School Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 1590434 | IN | Yes |
Addresses
Primary practice location
PO Box 8
Burket, IN 46508-0008
Mailing address
PO Box 8
Burket, IN 46508-0008
Phone (574) 598-2600
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 4, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.