Provider Demographics
NPI:1366161077
Name:ECKERT, KRISTYN (LMFT)
Entity type:Individual
Prefix:
First Name:KRISTYN
Middle Name:
Last Name:ECKERT
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1103 MILFORD WARREN GLEN RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMSBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:08804-2028
Mailing Address - Country:US
Mailing Address - Phone:908-529-0418
Mailing Address - Fax:
Practice Address - Street 1:1103 MILFORD WARREN GLEN RD
Practice Address - Street 2:
Practice Address - City:BLOOMSBURY
Practice Address - State:NJ
Practice Address - Zip Code:08804-2028
Practice Address - Country:US
Practice Address - Phone:908-529-0418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-25
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37FI00186200101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health