| C. Scott Eckholdt, Ph.d., Ltd., A Professional Psychology Corporation | |
|
800 Kaliste Saloom Rd Lafayette LA 70508-4210 | |
| (337) 233-2400 | |
| (337) 232-3656 |
| Full Name | C. Scott Eckholdt, Ph.d., Ltd., A Professional Psychology Corporation |
|---|---|
| Speciality | Psychologist |
| Location | 800 Kaliste Saloom Rd, Lafayette, Louisiana |
| Authorized Official Name and Position | Christopher Scott Eckholdt (OWNER/PRESIDENT) |
| Authorized Official Contact | 3375466280 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| C. Scott Eckholdt, Ph.d., Ltd., A Professional Psychology Corporation 800 Kaliste Saloom Rd Lafayette LA 70508-4210 Ph: (337) 233-2400 | C. Scott Eckholdt, Ph.d., Ltd., A Professional Psychology Corporation 800 Kaliste Saloom Rd Lafayette LA 70508-4210 Ph: (337) 233-2400 |
| NPI Number | 1295914059 |
|---|---|
| Provider Enumeration Date | 10/29/2007 |
| Last Update Date | 09/15/2009 |
| Medicare PECOS PAC ID | 7113008160 |
|---|---|
| Medicare Enrollment ID | O20080115000785 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295914059 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP0016X | Psychologist - Prescribing (medical) | 837MP (Louisiana) | Primary |
| Provider Name | Christopher S Eckholdt |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1649289919 PECOS PAC ID: 7719987148 Enrollment ID: I20071106000111 |
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