Provider Demographics
NPI:1235953266
Name:ECKELKAMP, PAIGE GRIFFIN (LCSW)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:GRIFFIN
Last Name:ECKELKAMP
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7351 18TH ST N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-4925
Mailing Address - Country:US
Mailing Address - Phone:908-616-3576
Mailing Address - Fax:
Practice Address - Street 1:7351 18TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-4925
Practice Address - Country:US
Practice Address - Phone:908-616-3576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-15
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW238181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical