Provider Demographics
NPI:1033901434
Name:JECKEL, STUART JOHN (LCSWA)
Entity type:Individual
Prefix:MR
First Name:STUART
Middle Name:JOHN
Last Name:JECKEL
Suffix:
Gender:M
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 ACTONWOODS RD
Mailing Address - Street 2:
Mailing Address - City:CANDLER
Mailing Address - State:NC
Mailing Address - Zip Code:28715-9601
Mailing Address - Country:US
Mailing Address - Phone:919-448-7479
Mailing Address - Fax:
Practice Address - Street 1:157 S LEXINGTON AVE UNIT B1
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-3677
Practice Address - Country:US
Practice Address - Phone:919-448-7479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-21
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0220491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical