Provider Demographics
NPI:1043766553
Name:ECKSTEIN, EMILY CARLSON (LCSW-C, LCSW, PMH-C)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:CARLSON
Last Name:ECKSTEIN
Suffix:
Gender:
Credentials:LCSW-C, LCSW, PMH-C
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:FAYE
Other - Last Name:CARLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LCSW-C, LCSW
Mailing Address - Street 1:12824 GRAND ELM ST
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20871-4392
Mailing Address - Country:US
Mailing Address - Phone:703-867-6939
Mailing Address - Fax:
Practice Address - Street 1:14915 BROSCHART RD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3350
Practice Address - Country:US
Practice Address - Phone:301-838-4912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-26
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD188941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical