Provider Demographics
NPI:1912367004
Name:ECHTERLING, TINA ROSE (MA)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:ROSE
Last Name:ECHTERLING
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:TINA
Other - Middle Name:
Other - Last Name:RIGDON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:9010 E 400 S
Mailing Address - Street 2:
Mailing Address - City:WOLCOTTVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46795-9731
Mailing Address - Country:US
Mailing Address - Phone:260-519-5055
Mailing Address - Fax:
Practice Address - Street 1:9010 E 400 S
Practice Address - Street 2:
Practice Address - City:WOLCOTTVILLE
Practice Address - State:IN
Practice Address - Zip Code:46795-9731
Practice Address - Country:US
Practice Address - Phone:260-519-5055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-02
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC7453101YA0400X, 101YM0800X
101YM0800X
IN39003428A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)